All 4 Me & Mommy PNCC CCC, LLC

Organization Active NPI Case Management Agency · Mequon, WI

NPI 1790448397 · NPPES record last updated Oct 22, 2021

Key facts

NPI
1790448397
Entity type
Organization (NPI type 2)
Primary specialty
Case Management Agency 251B00000X
Legal business name
ALL 4 ME & MOMMY PNCC CCC, LLC
Practice address
11051 N Towne Square Rd
Mequon, WI 53092-5051
Phone
(414) 755-2103
NPI assigned
Oct 20, 2021
Organization subpart
No

Authorized official

Name
Dariko Mekvabishvili
Title
President
Phone
(414) 745-3146

National Provider Directory

Locations

11051 N Towne Square Rd
Mequon, WI 53092
Phone (414) 755-2009

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Yes

Addresses

Primary practice location

11051 N Towne Square Rd
Mequon, WI 53092-5051

Mailing address

11051 N Towne Square Rd
Mequon, WI 53092-5051
Phone (414) 755-2103

Other providers in Mequon, WI

All providers in Mequon, WI · Case Management Agency in Wisconsin

Sources for this page

Verify at the official NPI Registry.