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General NPI Number Information
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NPI Number | 1285181735
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Entity Type | Organization
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Legal Business Name | AURORA FAMILY SERVICES
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 3200 W. HIGHLAND BLVD AURORA FAMILY SERVICES
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City | MILWAUKEE
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State | WI
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Zip | 53210
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Country | US
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Telephone | 414-345-4560
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Fax |
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Provider Business Mailing Address
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Address Line | 2410 N GRANT BLVD
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City | MILWAUKEE
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State | WI
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Zip | 53210-2940
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Country | US
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Telephone | 414-745-8949
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Fax |
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Authorized Official
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Title or Position | BEHAVIORAL HEALTH STUDENT
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Name | MRS. FELICIA DENISE HAYDEN
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Credential | MSW, APSW
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Telephone | 414-745-8949
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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 | 129104121
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License Number State | WI
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