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General NPI Number Information
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NPI Number | 1528301983
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Entity Type | Organization
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Legal Business Name | MS. CLEAN CLEANING SERVICE L.L.C.
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 04/18/2016
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Provider Practice Location Address
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Address Line | 2431 W GALENA ST
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City | MILWAUKEE
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State | WI
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Zip | 53205-1429
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Country | US
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Telephone | 414-534-9959
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Fax |
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Provider Business Mailing Address
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Address Line | 2431 W GALENA ST
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City | MILWAUKEE
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State | WI
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Zip | 53205-1429
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Country | US
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Telephone | 414-534-9959
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. NAKITA DEBERRY
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Credential | CERTIFIED IN PCW/SHC
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Telephone | 414-534-9959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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