| NPI | 1437945193 |
|---|---|
| Other Name | FANTASTIC CARES PNCC |
| Entity Type | Organization |
| Authorized Contact | LILLIE JACKSON Owner 414-807-3824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-04-17 |