Organization
EDUCATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA SARAH GENDELMAN (PRESIDENT)
(414) 687-4856
Entity
Organization
Contact information
Practice address
1317 W TOWNE SQUARE RD, MEQUON, WI 53092-5017
(414) 687-4856
Mailing address
10451 N STRATFORD PL, MEQUON, WI 53092-5554
(414) 687-4856
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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