Organization
GENTLE HEARTS PNCC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL COOPER (OWNER)
(414) 739-0959
Entity
Organization
Contact information
Practice address
5918 N 80TH ST, MILWAUKEE, WI 53218-1719
(414) 739-0959
Mailing address
5918 N 80TH ST, MILWAUKEE, WI 53218-1719
(414) 739-0959
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
05/08/2021
Last updated
05/08/2021
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