Provider Demographics
NPI:1821863614
Name:TAKE CONTROL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:TAKE CONTROL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:LATOSHA
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:414-293-2595
Mailing Address - Street 1:5474 N 26TH ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-4931
Mailing Address - Country:US
Mailing Address - Phone:414-326-6930
Mailing Address - Fax:
Practice Address - Street 1:756 N 35TH ST STE 201
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-3360
Practice Address - Country:US
Practice Address - Phone:414-293-2595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty