Organization
VIRGINIAS PLAYHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYETTA WILLIAMS (OWNER)
(414) 388-4186
Entity
Organization
Contact information
Practice address
4316 N 19TH PL, MILWAUKEE, WI 53209-6836
(414) 388-4186
(414) 388-4186
Mailing address
4316 N 19TH PL, MILWAUKEE, WI 53209-6836
(414) 388-4186
(414) 388-4186
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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