Organization
ABBY'S CLUBHOUSE / ABBY BOO INC
Active
Other names
Abby's Clubhouse, MTC Business
Organization subpart
No
Provider details
NPI number
Authorized official
CAPRICE MATHIES (OWNER)
(414) 242-1174
Entity
Organization
Contact information
Practice address
2640 W FONDULAC AVE, MILWAUKEE, WI 53206
(414) 514-3651
Mailing address
PO BOX 1052, MILWAUKEE, WI 53201-1052
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
04/27/2020
Last updated
02/05/2021
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