Match

NPI #1336205855 in Milwaukee, Wisconsin

Provider Information

NPI Number: 1336205855
Entity Type: Organization
Organization Name: Match
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Dec 29, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 2902 N 1ST ST
City: Milwaukee
State: Wisconsin
ZIP Code: 53212-2406
Phone: (414) 372-0739

Authorized Official

Name: MS. MERRY KYLES
Title: OWNER
Phone: (414) 372-0739

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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