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Organization
REVEIVE YOUTH AND FAMILY SERVICES
Active
Organization
REVEIVE YOUTH AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CRYSTAL A MCCLAIN CAPSW (THERAPIST)
(414) 763-6603
Entity
Organization
Contact information
Practice address
2518 N 17TH ST, MILWAUKEE, WI 53206-2020
(414) 915-2637
(414) 810-1567
Mailing address
2518 N17TH ST., MILWAUKEE, WI 53206
(414) 915-2637
(414) 810-1567
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
8035461
WI
Other
Enumeration date
04/29/2013
Last updated
04/29/2013
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