Organization
COMMUNITY CARE HOUSING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY RUSSELL (MEMBER)
(414) 241-1553
Entity
Organization
Contact information
Practice address
544 E OGDEN AVE, STE 700-268, MILWAUKEE, WI 53202-2698
(414) 241-1553
Mailing address
544 E OGDEN AVE, STE 700-268, MILWAUKEE, WI 53202-2698
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
WI
Other
Enumeration date
03/21/2011
Last updated
03/21/2011
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