Organization
BREATH OF NEW LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HUDSON (MEMBER)
(602) 418-7547
Entity
Organization
Contact information
Practice address
250 E WISCONSIN AVE, MILWAUKEE, WI 53202-4232
(262) 345-3191
Mailing address
4549 N 58TH ST, MILWAUKEE, WI 53218-5613
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/31/2020
Last updated
06/28/2022
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