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General NPI Number Information
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NPI Number | 1427335736
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Entity Type | Organization
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Legal Business Name | LEVISION, INC.
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Dates
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Enumeration Date | 11/15/2011
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 10721 WEST CAPITAL DRIVE 126
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City | MILWAUKEE
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State | WI
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Zip | 53222
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Country | US
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Telephone | 414-510-7704
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 830
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City | MILWAUKEE
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State | WI
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Zip | 53201-0830
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Country | US
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Telephone | 414-510-7704
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC SOCIAL WORKER
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Name | MS. BRENDA KAY STIFF
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Credential |
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Telephone | 414-510-7704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4145-123
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License Number State | WI
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