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General NPI Number Information
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NPI Number | 1417860768
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Entity Type | Organization
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Legal Business Name | BESTOW SERVICES INC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 2505 N 41ST ST
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City | MILWAUKEE
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State | WI
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Zip | 53210-2935
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Country | US
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Telephone | 414-788-1084
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Fax | 862-263-7319
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Provider Business Mailing Address
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Address Line | 2505 N 41ST ST
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City | MILWAUKEE
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State | WI
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Zip | 53210-2935
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Country | US
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Telephone | 414-788-1084
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Fax | 862-263-7319
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MICOLE JACKSON
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Credential |
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Telephone | 414-788-1084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NULL
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