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Organization
BROTOLOC SOUTH, INC.
Active
Organization
BROTOLOC SOUTH, INC.
Active
Parent organization
BROTOLOC SOUTH, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROTOLOC SOUTH, INC.
Authorized official
DOUG E SVEDA (DIRECTOR)
(414) 543-3200
Entity
Organization
Contact information
Practice address
5812 W BURNHAM ST, WEST ALLIS, WI 53219-1524
(414) 543-3200
(414) 543-3269
Mailing address
5812 W BURNHAM ST, WEST ALLIS, WI 53219-1524
(414) 543-3200
(414) 543-3269
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42207400
—
WI
Enumeration date
12/10/2009
Last updated
04/26/2010
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