Organization
PRIMROSE RESIDENTIAL FACILITY
Active
Other names
Community Based Residential Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY TEMPLE GLADNEY RN (ADMINISTRATOR)
(414) 445-3607
Entity
Organization
Contact information
Practice address
3910 W BURLEIGH ST, MILWAUKEE, WI 53210-1816
(414) 445-3607
(414) 445-6575
Mailing address
3910 W BURLEIGH ST, MILWAUKEE, WI 53210-1816
(414) 445-3607
(414) 445-4575
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
WI
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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