NPI 1043521156

St. Aemilian-Lakeside, INC.

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Milwaukee, WI

Practice location

Address: 8901 W Capitol Dr, Milwaukee, WI 53222-1706
Phone: (414) 465-1308
Fax: (414) 465-5788

Authorised official

Name: Bridget Fassett
Title: Chief Financial Officer
Phone: (414) 465-1308

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 265011 (WI)

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Registry record

NPI: 1043521156
Entity type: Organization
NPI issued: 24 Jun 2010
Record last updated: 24 Jun 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.