Organization
M.A.T.C.H.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MERRY KYLES (ONWER)
(414) 372-0739
Entity
Organization
Contact information
Practice address
2902 N 1ST ST, MILWAUKEE, WI 53212-2406
(414) 372-0739
Mailing address
2902 N 1ST ST, MILWAUKEE, WI 53212-2406
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
WI
Other
Enumeration date
02/23/2006
Last updated
08/22/2020
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