| NPI | 1720153653 |
|---|---|
| Other Name | LISBON AVENUE HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | CANDICE COLE CFO 414-935-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 1041C0700X Social Worker, Clinical | |
| 124Q00000X Dental Hygienist | |
| 122300000X Dentist | |
| 363LF0000X Nurse Practitioner, Family | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2017-01-25 |