Provider Demographics
NPI:1043306798
Name:CHILDREN'S FAMILY & COMMUNITY PARTNERSHIPS
Entity Type:Organization
Organization Name:CHILDREN'S FAMILY & COMMUNITY PARTNERSHIPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-453-1400
Mailing Address - Street 1:P. O. BOX 1127
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53082-1127
Mailing Address - Country:US
Mailing Address - Phone:920-457-6750
Mailing Address - Fax:920-457-8350
Practice Address - Street 1:2327 NO. 25 ST.
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53206
Practice Address - Country:US
Practice Address - Phone:414-933-3095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43084728Medicaid