Organization
NEW VINTAGE CHURCH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN PAUL BARTELME (SENIOR PASTOR/COUNSELOR)
(414) 400-8320
Entity
Organization
Contact information
Practice address
6626 W BELOIT RD, WEST ALLIS, WI 53219-2009
(414) 400-8320
Mailing address
6626 W BELOIT RD, WEST ALLIS, WI 53219-2009
(414) 400-8320
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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