MEDICARE: PALM SALVATION SERVICES

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1851247969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM SALVATION SERVICES

Provider Business Mailing Address
First Line	:	2266 N PROSPECT AVE STE 203
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-6306
Country	:	US
Telephone Number	:	414-534-3061
Fax Number	:

Provider Business Practice Location Address
First Line	:	2266 N PROSPECT AVE STE 203
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-6306
Country	:	US
Telephone Number	:	414-534-3061
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ DIRECTOR
Name	:	TIERA MONIQUE COLEMAN
Credential	:	COLEMAN
Telephone Number	:	414-534-3061

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “PALM SALVATION SERVICES ” Practice Location

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