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Organization
RETRAC ENTERPRISES INC
Active
Organization
RETRAC ENTERPRISES INC
Active
Other names
RETRAC Enterprises INC
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER ELLIS PHYSICIAN ASSISTANT (OWNER)
(414) 218-8670
Entity
Organization
Contact information
Practice address
4117 N GREEN BAY AVE, MILWAUKEE, WI 53209-7019
(414) 433-0780
(414) 433-5780
Mailing address
4117 N GREEN BAY AVE, MILWAUKEE, WI 53209-7019
(414) 218-8670
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760613327
—
WI
Enumeration date
04/05/2022
Last updated
09/02/2025
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