PRIMROSE RESIDENTIAL FACILITY NPI 1003064064

NPI Information

PRIMROSE RESIDENTIAL FACILITY is a community health clinic center in Milwaukee, WI. PRIMROSE RESIDENTIAL FACILITY NPI is 1003064064. The provider is registered as an organization entity type.
The provider Is Doing Business As Community Based Residential Facility.

The provider's business location address is:

3910 W BURLEIGH ST
MILWAUKEE, WI
ZIP 53210-816
Phone: (414) 445-3607
Fax: (414) 445-6575

The provider's authorized official is Shirley Temple Gladney .
The authorized official title is Administrator and has the following contact phone number (414) 445-3607.

The enumeration date for this NPI number is 9/3/2008 and was last updated on 9/3/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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