Provider Demographics
NPI:1790026649
Name:ROSALYN M GARWOOD
Entity Type:Organization
Organization Name:ROSALYN M GARWOOD
Other - Org Name:EMPOWERMENT CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSALYN
Authorized Official - Middle Name:MEDRICK
Authorized Official - Last Name:GARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-610-9565
Mailing Address - Street 1:7325 W MARINE DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-2013
Mailing Address - Country:US
Mailing Address - Phone:414-610-9565
Mailing Address - Fax:
Practice Address - Street 1:7325 W MARINE DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-2013
Practice Address - Country:US
Practice Address - Phone:414-610-9565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11384930251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1588613442Medicaid