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
9501 W WATERTOWN PLANK RD, WAUWATOSA, WI 53226-3552
(414) 476-3710
(414) 778-5985
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
1005239
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43018000
—
WI
Enumeration date
05/06/2008
Last updated
05/06/2008
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