Provider Demographics
NPI: | 1952608721 |
---|---|
Name: | COMMUNITY ADVOCATES, INC |
Entity Type: | Organization |
Organization Name: | COMMUNITY ADVOCATES, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANDI |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MALLMANN-ELLIOTT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 414-270-2941 |
Mailing Address - Street 1: | 728 N JAMES LOVELL ST |
Mailing Address - Street 2: | |
Mailing Address - City: | MILWAUKEE |
Mailing Address - State: | WI |
Mailing Address - Zip Code: | 53233-2408 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 414-270-2944 |
Mailing Address - Fax: | 414-270-2971 |
Practice Address - Street 1: | 4906 W FOND DU LAC AVE |
Practice Address - Street 2: | |
Practice Address - City: | MILWAUKEE |
Practice Address - State: | WI |
Practice Address - Zip Code: | 53216-2325 |
Practice Address - Country: | US |
Practice Address - Phone: | 414-449-4777 |
Practice Address - Fax: | 414-270-2971 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-02-14 |
Last Update Date: | 2018-03-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |