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Organization
WISCONSIN INDEPENDENT LIVING SERVICES LLC
Active
Organization
WISCONSIN INDEPENDENT LIVING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELIA SAMPTON FOSSIE MSW (PRESIDENT)
(414) 263-6000
Entity
Organization
Contact information
Practice address
2821 N 4TH ST, STE 516, MILWAUKEE, WI 53212-2362
(414) 263-6000
(414) 332-2523
Mailing address
2821 N 4TH ST, STE 516, MILWAUKEE, WI 53212-2362
(414) 263-6000
(414) 332-2523
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/19/2011
Last updated
01/03/2013
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