Organization
CAREER YOUTH DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STERLON WHITE III (AUTHORIZED OFFICIAL)
(414) 263-8352
Entity
Organization
Contact information
Practice address
2601 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-2711
(414) 263-8352
Mailing address
6400 INDUSTRIAL LOOP, GREENDALE, WI 53129-2452
(414) 423-4100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42170400
—
WI
Enumeration date
06/02/2008
Last updated
06/02/2008
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