Organization
HOUSE OF DAVID, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LURIDEAN NICHOLS (FOUNDER/CEO)
(414) 444-3013
Entity
Organization
Contact information
Practice address
4417 W NORTH AVE, MILWAUKEE, WI 53208-1241
(414) 444-3013
Mailing address
4417 W NORTH AVE, MILWAUKEE, WI 53208-1241
(414) 444-3013
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43086200
—
WI
Enumeration date
04/25/2008
Last updated
04/25/2008
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