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Organization
ST. AEMILIAN LAKESIDE
Active
Organization
ST. AEMILIAN LAKESIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA VAN ALSTINE (QUALITY ASSURANCE SPECIALIST)
(414) 463-1880
Entity
Organization
Contact information
Practice address
8901 W CAPITOL DR, MILWAUKEE, WI 53222-1706
(414) 463-1880
Mailing address
8901 W CAPITOL DR, MILWAUKEE, WI 53222-1706
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1586121
WI
Other
Enumeration date
05/15/2008
Last updated
05/16/2008
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