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General NPI Number Information
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NPI Number | 1417130071
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Entity Type | Organization
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Legal Business Name | MIDWEST COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 9401 W BELOIT RD 414
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City | MILWAUKEE
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State | WI
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Zip | 53227-4357
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Country | US
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Telephone | 414-327-4255
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Fax | 414-327-4655
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Provider Business Mailing Address
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Address Line | 9401 W BELOIT RD 414
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City | MILWAUKEE
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State | WI
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Zip | 53227-4357
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Country | US
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Telephone | 414-327-4255
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Fax | 414-327-4655
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. THOMAS ANTHONY NOWAK
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Credential | LCSW, ACSW
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Telephone | 414-327-4255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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