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NPI Code Detail

MEDICARE: MILWAUKEE HAPPY HOUSE LLC

MEDICARE: MILWAUKEE HAPPY HOUSE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2101Y00000XCounselor
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
4101YA0400XAddiction (Substance Use Disorder) Counselor
5225C00000XRehabilitation Counselor
6101YM0800XMental Health Counselor
7171400000XHealth & Wellness Coach

General Provider Information

NPI Number : 1124984380
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILWAUKEE HAPPY HOUSE LLC
Provider Business Mailing Address
First Line : 2107 N 36TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53208-1406
Country : US
Telephone Number : 414-460-3523
Fax Number :
Provider Business Practice Location Address
First Line : 2107 N 36TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53208-1406
Country : US
Telephone Number : 414-460-3523
Fax Number :
Authorized Official
Title or Position : ADMIN
Name : SHALANDA GREEN
Credential :
Telephone Number : 414-460-3523
Provider Enumeration Date : 01/01/2026
Last Update Date : 03/14/2026

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Directions to “MILWAUKEE HAPPY HOUSE LLC ” Practice Location

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