Provider Demographics
NPI:1306620323
Name:EDUCATES
Entity type:Organization
Organization Name:EDUCATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:SARAH
Authorized Official - Last Name:GENDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-687-4856
Mailing Address - Street 1:10451 N STRATFORD PL
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-5554
Mailing Address - Country:US
Mailing Address - Phone:414-687-4856
Mailing Address - Fax:
Practice Address - Street 1:1317 W TOWNE SQUARE RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5017
Practice Address - Country:US
Practice Address - Phone:414-687-4856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty