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General NPI Number Information
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NPI Number | 1215475876
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Entity Type | Organization
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Legal Business Name | FAMILY & BEHAVIORAL HEALTH CONCEPTS, LLC
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 8532 W CAPITOL DR
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City | MILWAUKEE
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State | WI
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Zip | 53222-1848
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Country | US
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Telephone | 414-375-0478
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Fax | 414-375-4048
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Provider Business Mailing Address
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Address Line | 2945 N 53RD ST
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City | MILWAUKEE
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State | WI
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Zip | 53210-1616
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Country | US
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Telephone | 414-375-0478
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Fax | 414-375-4048
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Authorized Official
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Title or Position | CEO/ADVANCED PRACTICE NURSE
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Name | RABANY CLAYBORN
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Credential | APNP
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Telephone | 414-375-0478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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