Organization
FOSTER CARE YOUTH INDEPENDENCE CENTER OF WISCONSIN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ALLEN PEKRUL (CHIEF EXECUTIVE OFFICER)
(414) 264-6290
Entity
Organization
Contact information
Practice address
2433 N HOLTON ST, MILWAUKEE, WI 53212-2934
(414) 264-6290
(414) 264-6073
Mailing address
2433 N HOLTON ST, MILWAUKEE, WI 53212-2934
(414) 264-6290
(414) 264-6073
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
07/31/2009
Last updated
07/31/2009
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