MEDICARE: ANGELS OF MENTALLY CHALLENGE

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	247200000X	Other Technician

General Provider Information

NPI Number	:	1861359523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELS OF MENTALLY CHALLENGE

Provider Business Mailing Address
First Line	:	2708 W CENTER ST APT 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-2648
Country	:	US
Telephone Number	:	601-741-7568
Fax Number	:

Provider Business Practice Location Address
First Line	:	2708 W CENTER ST APT 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-2648
Country	:	US
Telephone Number	:	601-741-7568
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GLORIA GUY
Credential	:
Telephone Number	:	601-741-7568

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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Directions to “ANGELS OF MENTALLY CHALLENGE ” Practice Location

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