NPI 1548659634

Kls Community Outreach Teen Center Consulting and Management L.L.C.

Organisation Early Intervention Provider Agency Brown Deer, WI

Practice location

Address: 8330 North Teutonia Avenue Suite 103, Brown Deer, WI 53209
Phone: (414) 236-5278
Fax: (414) 368-3051

Authorised official

Name: Kenya Latrice Smith
Title: Ceo
Phone: (414) 236-5278

Registered specialties

Early Intervention Provider Agency Primary

Agencies Taxonomy 252Y00000X

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Registry record

NPI: 1548659634
Entity type: Organization
NPI issued: 13 Jan 2015
Record last updated: 13 Jan 2015

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.