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General NPI Number Information
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NPI Number | 1558182527
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Entity Type | Organization
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Legal Business Name | LIFELINK BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 200 S EXECUTIVE DR # 2061
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City | BROOKFIELD
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State | WI
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Zip | 53005-4216
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Country | US
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Telephone | 414-800-9757
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Fax | 414-710-2556
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Provider Business Mailing Address
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Address Line | 200 S EXECUTIVE DR # 2061200S
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City | BROOKFIELD
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State | WI
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Zip | 53005-4216
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Country | US
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Telephone | 414-800-9757
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Fax | 414-710-2556
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Authorized Official
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Title or Position | DIRECTOR
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Name | MUSTAFA MOHAMED
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Credential |
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Telephone | 414-882-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #4
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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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