Organization
HUMAN DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUCK HOLLOWAY PH D (EXECUTIVE DIRECTOR)
(414) 449-9908
Entity
Organization
Contact information
Practice address
6833 W FOND DU LAC AVE, 3RD FLOOR, MILWAUKEE, WI 53218-3900
(414) 449-9908
Mailing address
PO BOX 274, MILWAUKEE, WI 53201-0274
(414) 449-9908
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2634
WI
101YM0800X
Mental Health Counselor
2634
WI
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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