MEDICARE: FOKUS FAMILY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	2473	WI
2	291U00000X	Clinical Medical Laboratory	52D2043078	WI
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WI2479	OTHER		MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164673133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOKUS FAMILY SERVICES LLC

Provider Business Mailing Address
First Line	:	2821 N VEL R PHILLIPS AVE STE 123
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-2370
Country	:	US
Telephone Number	:	414-264-4217
Fax Number	:	414-264-4218

Provider Business Practice Location Address
First Line	:	2821 N VEL R PHILLIPS AVE STE 123
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-2370
Country	:	US
Telephone Number	:	414-264-4217
Fax Number	:	414-264-4218

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. ELZORA DARLENE COLLINS
Credential	:	BS,CSAC-ICS
Telephone Number	:	414-264-4217

Provider Enumeration Date	:	10/08/2008
Last Update Date	:	06/21/2023

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Directions to “FOKUS FAMILY SERVICES LLC ” Practice Location

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