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General NPI Number Information
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NPI Number | 1831855444
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Entity Type | Organization
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Legal Business Name | THE SLM GROUP
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 2600 W FOND DU LAC AVE
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City | MILWAUKEE
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State | WI
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Zip | 53206-5320
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Country | US
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Telephone | 414-499-9241
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Fax |
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Provider Business Mailing Address
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Address Line | 6030 W GREENFIELD AVE
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City | WEST ALLIS
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State | WI
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Zip | 53214-5001
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Country | US
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Telephone | 414-671-9095
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARQUIS A YOUNG SR.
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Credential |
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Telephone | 262-893-0859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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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 | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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