Organization
EASTER SEALS SOUTHEAST WISCONSIN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE R SCHAEFER (COO)
(414) 963-5902
Entity
Organization
Contact information
Practice address
2222 S 114TH ST, WEST ALLIS, WI 53227-1031
(414) 449-4444
(414) 571-5568
Mailing address
2222 S 114TH ST, WEST ALLIS, WI 53227-1031
(414) 449-4444
(414) 571-5568
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0400X
Rehabilitation Clinic/Center
261QR0400X
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41209100
—
WI
Enumeration date
12/22/2005
Last updated
08/18/2014
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