Organization
ST. CHARLES YOUTH & FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHERINE CONNOLLY (PRESIDENT)
(414) 476-3710
Entity
Organization
Contact information
Practice address
310 TROY DR, COTTAGE B, MADISON, WI 53704
(608) 663-5910
Mailing address
151 S 84TH ST, MILWAUKEE, WI 53214-1456
(414) 476-3710
(414) 778-5985
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
1011445
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43009100
—
WI
Enumeration date
05/09/2008
Last updated
05/09/2008
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