Provider Demographics
| NPI: | 1710784087 |
|---|---|
| Name: | VILLAGE 1848 LLC |
| Entity type: | Organization |
| Organization Name: | VILLAGE 1848 LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DONALD |
| Authorized Official - Middle Name: | D |
| Authorized Official - Last Name: | DANIELS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 414-208-1717 |
| Mailing Address - Street 1: | PO BOX 90012 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MILWAUKEE |
| Mailing Address - State: | WI |
| Mailing Address - Zip Code: | 53209-0012 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 414-533-5620 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 3904 N 68TH ST |
| Practice Address - Street 2: | |
| Practice Address - City: | MILWAUKEE |
| Practice Address - State: | WI |
| Practice Address - Zip Code: | 53216-2012 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 414-533-5620 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | VILLAGE COALITION LTD |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2025-02-25 |
| Last Update Date: | 2025-02-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 1041S0200X | Behavioral Health & Social Service Providers | Social Worker | School | Group - Multi-Specialty |
| No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
| No | 174200000X | Other Service Providers | Meals | ||
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
| No | 372500000X | Nursing Service Related Providers | Chore Provider | Group - Multi-Specialty | |
| No | 372600000X | Nursing Service Related Providers | Adult Companion | Group - Multi-Specialty | |
| No | 385H00000X | Respite Care Facility | Respite Care | Group - Multi-Specialty | |
| No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child | |
| No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |