Organization
ST. ROSE YOUTH & FAMILY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MARO LCSW (CEO/PRESIDENT)
(414) 466-9450
Entity
Organization
Contact information
Practice address
3801 N 88TH ST, MILWAUKEE, WI 53222-2706
(414) 466-9450
(414) 466-0730
Mailing address
3801 N 88TH ST, MILWAUKEE, WI 53222-2706
(414) 466-9450
(414) 466-0730
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1876
WI
101YM0800X
Mental Health Counselor
Primary
1876
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42220200
—
WI
Enumeration date
11/07/2007
Last updated
11/07/2007
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