Provider Demographics
NPI:1831774140
Name:GENERATION OF EXCELLENCE TRENDSETTERS
Entity type:Organization
Organization Name:GENERATION OF EXCELLENCE TRENDSETTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
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 1:6625 W MILL RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-1238
Mailing Address - Country:US
Mailing Address - Phone:414-526-5687
Mailing Address - Fax:
Practice Address - Street 1:6633 W MILL RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-1238
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:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty