Whalio Doctors

NPI 1477192359

I'M a Star Youth and Family Services INC

Organisation Point of Service Milwaukee, WI

Practice location

Address
4007 W North Ave, Milwaukee, WI 53208-1318
Phone
(414) 888-1710
Mailing address
2969 N 46th St, Milwaukee, WI 53210-1727

Authorised official

Name
Shakinas Robinson
Title
Authorized Agent
Phone
(414) 888-1710

Registered specialties

Point of Service Primary
Managed Care Organizations Taxonomy 305S00000X

Registry record

NPI
1477192359
Entity type
Organization
NPI issued
25 Dec 2019
Record last updated
27 Dec 2019

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.