Organization
ST. CHARLES YOUTH & FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT ANTHONY CARPENTER (VICE PRESIDENT)
(414) 476-3710
Entity
Organization
Contact information
Practice address
301 TROY DR, COTTAGE A, MADISON, WI 53704-1521
(608) 663-5913
(608) 663-5915
Mailing address
151 S 84TH ST, MILWAUKEE, WI 53214-1456
(414) 476-3710
(414) 778-5985
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43018000
—
WI
Enumeration date
04/23/2009
Last updated
04/23/2009
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