Organization
THE INSTITUTE FOR SOCIAL ADVANCEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUCK HOLLOWAY PH.D (PRESIDENT)
(414) 449-9908
Entity
Organization
Contact information
Practice address
4222 W CAPITOL DR, LOWER LEVEL, MILWAUKEE, WI 53216-2500
(414) 449-9908
(414) 449-9912
Mailing address
PO BOX 274, MILWAUKEE, WI 53201-0274
(414) 449-9908
(414) 449-9912
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44018400
—
WI
Enumeration date
05/06/2008
Last updated
01/18/2011
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