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NPI Code Detail

MEDICARE: NORTHSIDE FAMILY RESOURCES LLC

MEDICARE: NORTHSIDE FAMILY RESOURCES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist
2251B00000XCase Management Agency

General Provider Information

NPI Number : 1295462984
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHSIDE FAMILY RESOURCES LLC
Provider Business Mailing Address
First Line : 16625 CHERRY HILL DR
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-2716
Country : US
Telephone Number : 414-553-4965
Fax Number :
Provider Business Practice Location Address
First Line : 1917 W FINN PL
Second Line :
City : MILWAUKEE
State : WI
Zip : 53206-2319
Country : US
Telephone Number : 414-208-4229
Fax Number :
Authorized Official
Title or Position : MANAGER STUDENT
Name : MS. DION HOLLINGSWORTH L
Credential : STUDENT
Telephone Number : 414-533-4965
Provider Enumeration Date : 08/03/2022
Last Update Date : 11/23/2025

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Directions to “NORTHSIDE FAMILY RESOURCES LLC ” Practice Location

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