Organization
HANDS OF LIFE PNCC LLC
Active
Other names
Hands of Life PNCC
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA C VALENTINE JACKSON (ADMINISTRATOR)
(859) 550-0252
Entity
Organization
Contact information
Practice address
915 W NORTH AVE, MILWAUKEE, WI 53205-1330
(859) 550-0252
Mailing address
915 W NORTH AVE, MILWAUKEE, WI 53205-1330
(859) 550-0252
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/25/2022
Last updated
10/25/2022
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