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General NPI Number Information
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NPI Number | 1740373463
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR MENTAL HEALTH SC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 9401 W BELOIT RD SUITE 315
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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 | 414-321-4908
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Fax | 414-321-4914
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Provider Business Mailing Address
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Address Line | 9401 W BELOIT RD SUITE 315
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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 | 414-321-4908
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Fax | 414-321-4914
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN M. ROHR
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Credential | M.D.
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Telephone | 262-821-6060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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