Organization
ST. CHARLES YOUTH & FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDITH M HICKEY LCSW (PROGRAM MANAGER MENTAL HEALTH CLINI)
(414) 358-4167
Entity
Organization
Contact information
Practice address
4757 N 76TH ST, MILWAUKEE, WI 53218-4732
(414) 358-4173
(414) 358-5005
Mailing address
4757 N 76TH ST, MILWAUKEE, WI 53218-4732
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
4296-125
WI
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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