ST. AEMILIAN-LAKESIDE INC. NPI 1043521156

NPI Information

ST. AEMILIAN-LAKESIDE, INC. is a residential treatment facility emotionally disturbed children in Milwaukee, WI. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. ST. AEMILIAN-LAKESIDE, INC. NPI is 1043521156. The provider is registered as an organization entity type.

The provider's business location address is:

8901 W CAPITOL DR
MILWAUKEE, WI
ZIP 53222-706
Phone: (414) 465-1308
Fax: (414) 465-5788

The provider's authorized official is Bridget Fassett .
The authorized official title is Chief Financial Officer and has the following contact phone number (414) 465-1308.

The enumeration date for this NPI number is 6/24/2010 and was last updated on 6/24/2010.

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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