Organization
PRESTIGIOUS ACADEMY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EB COLEMAN (PRESIDENT)
(414) 702-3792
Entity
Organization
Contact information
Practice address
2624 N 16TH ST, MILWAUKEE, WI 53206-2014
(414) 265-8181
(414) 265-7998
Mailing address
2624 N 16TH ST, MILWAUKEE, WI 53206-2014
(414) 265-8181
(414) 265-7998
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
LZ-0000183
WI
Other
Enumeration date
01/08/2018
Last updated
03/17/2018
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