NPI 1124469804

Annette E Madison

Organisation Community/Behavioral Health Agency Brown Deer, WI

Practice location

Address: 6051 W Brown Deer Rd Suite 106, Brown Deer, WI 53223-2263
Phone: (414) 354-1030
Fax: (414) 354-7584
Mailing address: PO Box 90108, Milwaukee, WI 53209-0108

Authorised official

Name: Annette Elisa Madison
Title: Owner
Phone: (414) 354-1030

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 7034-123 (WI)

Other Community/Behavioral Health providers in Wisconsin →

Registry record

NPI: 1124469804
Entity type: Organization
NPI issued: 10 Jul 2013
Record last updated: 3 Jul 2014

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.