Healthcare Provider Details

I. General information

NPI: 1992081954
Provider Name (Legal Business Name): NRS SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2011
Last Update Date: 10/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 W BELOIT RD STE 416
MILWAUKEE WI
53227-4357
US

IV. Provider business mailing address

9401 W BELOIT RD STE 416 PO BOX 270325
MILWAUKEE WI
53227-4357
US

V. Phone/Fax

Practice location:
  • Phone: 414-587-3033
  • Fax:
Mailing address:
  • Phone: 414-587-3033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1671
License Number StateWI

VIII. Authorized Official

Name: MR. THOMAS ANTHONY NOWAK
Title or Position: DIRECTOR
Credential: ACSW, LCSW
Phone: 414-587-3033