IndividualActive
Antoinette Jackson
NPI 1144196387 · Mental Illness Community Based Residential Treatment Facility · Milwaukee, WI
Provider details
- NPI number
- 1144196387
- Entity type
- Individual
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
3925 N 6th St
Milwaukee, WI 53212-1139
Phone: (414) 234-7720
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 43
Mequon, WI 53092-0043
Registry dates
- Enumerated
- 2025-10-15
- Last updated
- 2025-10-15
- Certified
- 2025-10-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.