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Organization

CREATING BRIGHTER FUTURES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAQUONDA S BOGAN (CEO)
(414) 712-8221
Entity
Organization

Contact information

Practice address
4722 N 68TH ST, MILWAUKEE, WI 53218-4826
(414) 712-8221
Mailing address
4722 N 68TH ST, MILWAUKEE, WI 53218-4826
(414) 712-8221

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
10/12/2021
Last updated
10/12/2021
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