OrganizationActive
Impacthealth
NPI 1952709206 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Milwaukee, WI
Provider details
- NPI number
- 1952709206
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Yvette Johnson-Towers, Directot(414) 771-0453
- License
- 101528-30 (WI)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 101528-30 (WI)
Residential Treatment Facilities
Practice location
3219 N 51st Blvd
Milwaukee, WI 53216-3235
Phone: (414) 771-0543
Approximate (ZIP-level) locationGet directions
Mailing address
3219 N 51st Blvd
Milwaukee, WI 53216-3235
Registry dates
- Enumerated
- 2014-12-18
- Last updated
- 2014-12-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.