Organization
DESTANI'S CHILD MEDICAL DAYCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE M GORDEN RN (EXECUTIVE DIRECTOR)
(414) 217-2495
Entity
Organization
Contact information
Practice address
3062 N 58TH ST, SUITE 200, MILWAUKEE, WI 53210-1545
(414) 217-2495
(414) 445-3893
Mailing address
3062 N 58TH ST, MILWAUKEE, WI 53210-1545
(141) 217-2495
(414) 445-3893
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
109525
WI
Other
Enumeration date
02/21/2013
Last updated
02/21/2013
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