Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JOHN C BLAKE
Active Sole ProprietorJOHN C BLAKE is a Emotionally Disturbed Children Residential Treatment healthcare provider located in OSHKOSH, Wisconsin. NPI 1134924475 is currently active in the NPPES registry. Verify at CMS.
Emotionally Disturbed Children Residential Treatment · OSHKOSH, WI
Registration Details
- NPI Number
- 1134924475
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 19, 2025 (1.5271916575027 yrs)
- Last Updated
- Feb 19, 2025
- License
-
0017165 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
50 PEARL AVE STE 102OSHKOSH, WI, 549014811Browse WI providers · Browse ZIP 54901
- Phone
- 4143457781
- Fax
- 8664962680
- Primary Specialty
-
Emotionally Disturbed Children Residential Treatment
320900000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.