Individual
CORNELIUS MCCLENDON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPI, CBRF
Contact information
Practice address
5277 N 29TH ST APT 1, MILWAUKEE, WI 53209-4853
(262) 757-5210
(414) 800-1707
Mailing address
5277 N 29TH ST APT 3, MILWAUKEE, WI 53209-4853
(262) 757-5210
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
0016620
WI
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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