| Locke Consulting Services Company | |
|
9020 15th Ave Kenosha WI 53143-6803 | |
| (708) 224-7442 | |
| Not Available |
| Full Name | Locke Consulting Services Company |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9020 15th Ave, Kenosha, Wisconsin |
| Authorized Official Name and Position | Shellie Dee Locke (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7082247442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Locke Consulting Services Company 9020 15th Ave Kenosha WI 53143-6803 Ph: (708) 224-7442 | Locke Consulting Services Company 9020 15th Ave Kenosha WI 53143-6803 Ph: (708) 224-7442 |
| NPI Number | 1184894628 |
|---|---|
| Provider Enumeration Date | 03/11/2008 |
| Last Update Date | 03/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184894628 | NPI | - | NPPES |
| 40994300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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