Matt Talbot Recovery Services, Inc.

NPI #1174992895 in Milwaukee, Wisconsin

Provider Information

NPI Number: 1174992895
Entity Type: Organization
Organization Name: Matt Talbot Recovery Services, Inc.
Primary Specialty: Substance Abuse Rehabilitation Facility
Enumeration Date: Sep 23, 2015
Last Updated: Sep 23, 2015

Practice Location

Address: 2613 W NORTH AVE
City: Milwaukee
State: Wisconsin
ZIP Code: 53205-1056
Phone: (414) 342-5474

Authorized Official

Name: ANTONEO DESHAZOR
Title: EXECUTIVE DIRECTOR
Phone: (414) 793-3896

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X
Substance Abuse Rehabilitation Facility	324500000X	Primary

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