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General NPI Number Information
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NPI Number | 1770916645
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Entity Type | Organization
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Legal Business Name | LEARNING ENTERPRISE, LLC
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 3308 N 46TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53216-3331
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Country | US
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Telephone | 414-745-0925
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Fax |
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Provider Business Mailing Address
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Address Line | 3308 N. 46TH
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City | MILWAUKEE
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State | WI
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Zip | 53216
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Country | US
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Telephone | 414-745-0925
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | HENRY EDWARD TYLER
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Credential | M.ED
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Telephone | 414-745-0925
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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 | L052978
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License Number State | WI
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