Provider Demographics
NPI:1396203121
Name:A BEAUTIFUL START TO A BRIGHTER FUTURE
Entity Type:Organization
Organization Name:A BEAUTIFUL START TO A BRIGHTER FUTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-331-5896
Mailing Address - Street 1:3343 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1428
Mailing Address - Country:US
Mailing Address - Phone:414-331-5896
Mailing Address - Fax:414-979-0125
Practice Address - Street 1:3343 N 3RD ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-1428
Practice Address - Country:US
Practice Address - Phone:414-331-5896
Practice Address - Fax:414-979-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management