Organization
CARMELITE HOME, INC
Active
Other names
Carmelite Home for Boys
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E. LEWIS M.S.W.I.C.S.W. (DIRECTOR)
(414) 258-4791
Entity
Organization
Contact information
Practice address
1214 KAVANAUGH PL, WAUWATOSA, WI 53213-2506
(414) 258-4791
(414) 258-8464
Mailing address
1214 KAVANAUGH PL, WAUWATOSA, WI 53213-2506
(414) 258-4791
(414) 258-8464
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43016800
43016800 NPI PROVIDER # (OLD)
WI
Enumeration date
04/29/2008
Last updated
04/29/2008
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