Provider Demographics
NPI:1033481916
Name:TALITHA CUMI
Entity Type:Organization
Organization Name:TALITHA CUMI
Other - Org Name:TALITHA CUMI: WOMEN AND INFANTS CENTER FOR QUALITY LIFE
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-795-8419
Mailing Address - Street 1:6239 W BOEHLKE AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-5410
Mailing Address - Country:US
Mailing Address - Phone:414-795-8419
Mailing Address - Fax:
Practice Address - Street 1:6239 W BOEHLKE AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-5410
Practice Address - Country:US
Practice Address - Phone:414-795-8419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management