Healthcare Provider Details

I. General information

NPI: 1982901542
Provider Name (Legal Business Name): MILWAUKEE COUNTY MENTAL HEALTH DIVISION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 W WATERTOWN PLANK RD
MILWAUKEE WI
53226-3558
US

IV. Provider business mailing address

9201 W WATERTOWN PLANK RD
MILWAUKEE WI
53226-3558
US

V. Phone/Fax

Practice location:
  • Phone: 414-257-7405
  • Fax: 414-454-4242
Mailing address:
  • Phone: 414-257-7405
  • Fax: 414-454-4242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number1033379748
License Number StateWI

VIII. Authorized Official

Name: MR. WALTER LAUX
Title or Position: COMMUNITY SERVICE DIRECTOR
Credential:
Phone: 414-257-8095