Organization
GRAND RISING PNCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIQUITA S SHADWICK (CEO)
(414) 526-1431
Entity
Organization
Contact information
Practice address
1620 N 29TH ST, MILWAUKEE, WI 53208-2009
(414) 526-1541
Mailing address
1620 N 29TH ST, MILWAUKEE, WI 53208-2009
(414) 526-1431
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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