NPI 1114548542
Abby's Clubhouse / Abby Boo INC
Practice location
- Address
- 2640 W Fondulac Ave, Milwaukee, WI 53206
- Phone
- (414) 514-3651
- Mailing address
- PO Box 1052, Milwaukee, WI 53201-1052
Authorised official
- Name
- Caprice Mathies
- Title
- Owner
- Phone
- (414) 242-1174
Registered specialties (5)
Early Intervention Provider Agency
Primary
Case Management Agency
Nursing Care Agency
Public Health or Welfare Agency
In Home Supportive Care Agency
Registry record
- NPI
- 1114548542
- Entity type
- Organization
- NPI issued
- 27 Apr 2020
- Record last updated
- 5 Feb 2021
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.