MEDICARE: SOLACE GROVE BEHAVIORAL HEALTH INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	324500000X	Substance Abuse Rehabilitation Facility
3	3245S0500X	Children's Substance Abuse Rehabilitation Facility
4	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1255283701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLACE GROVE BEHAVIORAL HEALTH INC

Provider Business Mailing Address
First Line	:	9235 W CAPITOL DR STE 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-1567
Country	:	US
Telephone Number	:	480-485-7262
Fax Number	:

Provider Business Practice Location Address
First Line	:	9235 W CAPITOL DR STE 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-1567
Country	:	US
Telephone Number	:	480-485-7262
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	KEANA SPENCER
Credential	:
Telephone Number	:	480-485-7262

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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