Healthcare Provider Details

I. General information

NPI: 1154786697
Provider Name (Legal Business Name): ACCESS RECOVERY MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 W CLEVELAND AVE SUITE 204
MILWAUKEE WI
53215-2956
US

IV. Provider business mailing address

2727 W CLEVELAND AVE SUITE 204
MILWAUKEE WI
53215
US

V. Phone/Fax

Practice location:
  • Phone: 612-250-9590
  • Fax:
Mailing address:
  • Phone: 414-269-8356
  • Fax: 414-455-1915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MOHAMED YAROW
Title or Position: CEO
Credential:
Phone: 414-269-8356