Provider Demographics
NPI:1356009989
Name:WISCONSIN NURTURING & FAMILY SERVICES
Entity Type:Organization
Organization Name:WISCONSIN NURTURING & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-397-3447
Mailing Address - Street 1:3931 W KILEY AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2313
Mailing Address - Country:US
Mailing Address - Phone:414-397-3447
Mailing Address - Fax:
Practice Address - Street 1:3931 W KILEY AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-2313
Practice Address - Country:US
Practice Address - Phone:414-397-3447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency