| Carol L Flanary, Llc | |
|
12645 W Burleigh Rd Suite 20 Brookfield WI 53005-3102 | |
| (414) 339-5559 | |
| Not Available |
| Full Name | Carol L Flanary, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 12645 W Burleigh Rd, Brookfield, Wisconsin |
| Authorized Official Name and Position | Carol Flanary (OWNER MEMBER) |
| Authorized Official Contact | 4143395559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carol L Flanary, Llc 12645 W Burleigh Rd Suite 20 Brookfield WI 53005-3102 Ph: (414) 339-5559 | Carol L Flanary, Llc 12645 W Burleigh Rd Suite 20 Brookfield WI 53005-3102 Ph: (414) 339-5559 |
| NPI Number | 1982016846 |
|---|---|
| Provider Enumeration Date | 05/27/2014 |
| Last Update Date | 05/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982016846 | NPI | - | NPPES |
| 1144487844 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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