Healthcare Provider Details

I. General information

NPI: 1326402538
Provider Name (Legal Business Name): ALORIA HEALTH MILWAUKEE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 E WISCONSIN AVE SUITE 220
MILWAUKEE WI
53202-4310
US

IV. Provider business mailing address

312 E WISCONSIN AVE SUITE 220
MILWAUKEE WI
53202-4310
US

V. Phone/Fax

Practice location:
  • Phone: 414-488-3503
  • Fax:
Mailing address:
  • Phone: 414-488-3503
  • Fax: 414-488-3600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateWI

VIII. Authorized Official

Name: MISS ELIZABETH ANN TOOHILL
Title or Position: CHIEF NURSING OFFICER
Credential: MSN,CCM,CRRN
Phone: 224-500-1931