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Organization

JABEZ TRANSITIONAL LIVING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHERRI A BOND (EXECUTIVE DIRECTOR)
(414) 462-5532
Entity
Organization

Contact information

Practice address
5926 N TEUTONIA AVE, MILWAUKEE, WI 53209-4148
(414) 462-5532
(414) 462-5529
Mailing address
5926 N TEUTONIA AVE, MILWAUKEE, WI 53209-4148
(414) 462-5532
(414) 462-5529

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100012658
WI
Enumeration date
12/13/2010
Last updated
12/13/2010
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