Organization
KIDS IN TRANSITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLEON EDWARD SUGGS C.S.A.C.,I.C.S. (CLINICAL SUPERVISOR)
(414) 688-3062
Entity
Organization
Contact information
Practice address
6314 N 104TH ST, MILWAUKEE, WI 53225-1408
(414) 688-3062
(414) 277-8916
Mailing address
6314 N 104TH ST, MILWAUKEE, WI 53225-1408
(414) 688-3062
(414) 277-8916
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
10600132
WI
251S00000X
Community/Behavioral Health Agency
Primary
11828134
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39387800
—
WI
Enumeration date
01/21/2009
Last updated
01/21/2009
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