Healthcare Provider Details

I. General information

NPI: 1952392706
Provider Name (Legal Business Name): COPE BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 N 4TH ST SUITE 121
MILWAUKEE WI
53212-2362
US

IV. Provider business mailing address

6400 INDUSTRIAL LOOP
GREENDALE WI
53129-2452
US

V. Phone/Fax

Practice location:
  • Phone: 414-265-5112
  • Fax: 414-265-4140
Mailing address:
  • Phone: 414-423-4100
  • Fax: 414-423-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MR. BALFORD FRANCIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 414-423-4100