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General NPI Number Information
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NPI Number | 1053394841
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES OF THE ARCHDIOCESE OF MILWAUKEE INC
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Dates
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Enumeration Date | 11/25/2005
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 717 N EAST AVE
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City | WAUKESHA
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State | WI
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Zip | 53186-4906
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Country | US
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Telephone | 262-547-2463
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Fax | 262-547-8002
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Provider Business Mailing Address
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Address Line | 717 N EAST AVE
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City | WAUKESHA
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State | WI
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Zip | 53186-4806
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Country | US
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Telephone | 262-547-2463
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Fax | 262-547-8002
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. JULIE A BUSH
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Credential |
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Telephone | 262-637-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 1134
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License Number State | WI
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