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General NPI Number Information
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NPI Number | 1750145009
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Entity Type | Organization
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Legal Business Name | REHEMA MENTAL WELLNESS LLC
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1225 12TH AVE
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City | GRAFTON
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State | WI
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Zip | 53024-1923
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Country | US
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Telephone | 262-300-7976
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 12TH AVE
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City | GRAFTON
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State | WI
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Zip | 53024-1923
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. REUEL KAGAMBA MUIRURI
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Credential |
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Telephone | 262-300-7976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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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 | 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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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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