Provider Demographics
NPI:1053858019
Name:WISE MANAGEMENT INC.
Entity Type:Organization
Organization Name:WISE MANAGEMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-534-2979
Mailing Address - Street 1:N94W20846 SCHLEI RD
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-1127
Mailing Address - Country:US
Mailing Address - Phone:414-534-2979
Mailing Address - Fax:888-530-6040
Practice Address - Street 1:1538 W LIEBAU RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-2621
Practice Address - Country:US
Practice Address - Phone:414-534-2979
Practice Address - Fax:888-530-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness