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NPI 1518728526

NPI 1518728526 : OUR JOURNEY TOGETHER : MILWAUKEE, WI

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General NPI Number Information
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    NPI Number           |    1518728526
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    Entity Type          |    Organization 
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    Legal Business Name  |    OUR JOURNEY TOGETHER 
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Dates
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    Enumeration Date     |    01/17/2024
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    Last Update Date     |    01/17/2024
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Provider Practice Location Address
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    Address Line         |    3925 N 82ND ST 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53222-2936
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    Country              |    US
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    Telephone            |    414-295-1213
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3925 N 82ND ST 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53222-2936
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    Country              |    US
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    Telephone            |    414-295-1213
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     DANITA  CHAMPION 
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    Credential           |    
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    Telephone            |    414-295-1213
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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 |    
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Taxonomy #2
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    Taxonomy Code        |    372600000X
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    Taxonomy Name        |    Adult Companion
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    License Number       |    
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    License Number State |    
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