Provider Demographics
NPI:1821673146
Name:GENERATION OF EXCELLENCE TRENDSETTERS
Entity Type:Organization
Organization Name:GENERATION OF EXCELLENCE TRENDSETTERS
Other - Org Name:LATONYA BAKER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CECEO
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:ANTREASE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-526-5687
Mailing Address - Street 1:2975 RIVER BIRCH DR UNIT F
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-3491
Mailing Address - Country:US
Mailing Address - Phone:414-526-5687
Mailing Address - Fax:
Practice Address - Street 1:2200 WASHINGTON AVE APT 121
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405-3575
Practice Address - Country:US
Practice Address - Phone:414-526-5687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management