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General NPI Number Information
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NPI Number | 1275088981
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Entity Type | Organization
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Legal Business Name | M.C. PREPARATORY SCHOOL OF WISCONSIN INC
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 1228 W LLOYD ST
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City | MILWAUKEE
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State | WI
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Zip | 53205-1243
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Country | US
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Telephone | 414-264-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1228 W LLOYD ST
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City | MILWAUKEE
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State | WI
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Zip | 53205-1243
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Country | US
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Telephone | 414-264-6000
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JON OSMAN
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Credential |
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Telephone | 414-264-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | WI
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