MEDICARE: SERVICES FOR FAMILIES, 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1639452683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERVICES FOR FAMILIES, LLC

Provider Business Mailing Address
First Line	:	1538 N 40TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-2335
Country	:	US
Telephone Number	:	414-364-2688
Fax Number	:

Provider Business Practice Location Address
First Line	:	4907 W CENTER ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-2310
Country	:	US
Telephone Number	:	414-207-4525
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DENNA THOMPSON
Credential	:
Telephone Number	:	414-364-2688

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/26/2011

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