Provider Demographics
NPI:1629155973
Name:AALTO ENHANCEMENT CENTER, S.C.
Entity Type:Organization
Organization Name:AALTO ENHANCEMENT CENTER, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:AALTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,MSW
Authorized Official - Phone:262-654-9370
Mailing Address - Street 1:8503 75TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-7620
Mailing Address - Country:US
Mailing Address - Phone:262-654-9370
Mailing Address - Fax:262-654-9379
Practice Address - Street 1:8503 75TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-7620
Practice Address - Country:US
Practice Address - Phone:262-654-9370
Practice Address - Fax:262-654-9379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1083261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000032165Medicare ID - Type Unspecified