Organization
FIRST CLASS CARE WISCONSIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IGONI IGONI (CO OWNER)
(414) 763-2072
Entity
Organization
Contact information
Practice address
5441 N 73RD ST, MILWAUKEE, WI 53218-2826
(414) 763-2072
Mailing address
5441 N 73RD ST, MILWAUKEE, WI 53218-2826
(414) 763-2072
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
0015719
WI
Other
Enumeration date
07/19/2017
Last updated
07/21/2022
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