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Organization

GRACEFUL SMILES NURTURING HAND

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MONICA NICOLE JOHNSON (CEO)
(262) 207-4056
Entity
Organization

Contact information

Practice address
6040 W LISBON AVE STE B6, MILWAUKEE, WI 53210-2116
(262) 207-4056
(414) 488-2854
Mailing address
6040 W LISBON AVE STE B6, MILWAUKEE, WI 53210-2116
(262) 207-4056
(414) 488-2854

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
02/04/2017
Last updated
02/04/2017
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