Provider Demographics
NPI:1184498057
Name:READY SET GROW PRENATAL CARE COORDINATION STUDIO
Entity type:Organization
Organization Name:READY SET GROW PRENATAL CARE COORDINATION STUDIO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHIRRON
Authorized Official - Middle Name:
Authorized Official - Last Name:JUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-610-1886
Mailing Address - Street 1:2155 W MILL RD APT 208
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-3462
Mailing Address - Country:US
Mailing Address - Phone:414-610-1886
Mailing Address - Fax:
Practice Address - Street 1:6091 N TEUTONIA AVE STE 105
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-3644
Practice Address - Country:US
Practice Address - Phone:262-825-2470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:READY SET GROW PRENATAL CARE COORDINATION STUDIO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-13
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100285832Medicaid