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General NPI Number Information
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NPI Number | 1649338120
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Entity Type | Organization
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Legal Business Name | ASSOCIATED MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5555 N PORT WASHINGTON RD STE 200
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City | MILWAUKEE
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State | WI
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Zip | 53217
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Country | US
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Telephone | 414-962-6100
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Fax | 414-962-6470
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Provider Business Mailing Address
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Address Line | 5555 N PORT WASHINGTON RD STE 200
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City | MILWAUKEE
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State | WI
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Zip | 53217
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Country | US
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Telephone | 414-962-6100
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Fax | 414-962-6470
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Authorized Official
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Title or Position | CEO
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Name | JOHN WILLIAM CARPENTER
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Credential | MD
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Telephone | 414-962-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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