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Organization
CARMELITE HOME, INC
Active
Organization
CARMELITE HOME, INC
Active
Other names
Carmelite Home for Boys
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E. LEWIS M.S.W.I.C.S.W. (DIRECTOR)
(414) 258-4791
Entity
Organization
Contact information
Practice address
1214 KAVANAUGH PL, WAUWATOSA, WI 53213-2506
(414) 258-4791
(414) 258-8464
Mailing address
1214 KAVANAUGH PL, WAUWATOSA, WI 53213-2506
(414) 258-4791
(414) 258-8464
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43016800
43016800 NPI PROVIDER # (OLD)
WI
Enumeration date
04/29/2008
Last updated
04/29/2008
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