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NPI Code Detail

MEDICARE: MILWAUKEE HEALTH SERVICES SYSTEM, LLC

MEDICARE: MILWAUKEE HEALTH SERVICES SYSTEM, 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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2261QM2800XMethadone Clinic

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144684697
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILWAUKEE HEALTH SERVICES SYSTEM, LLC
Provider Business Mailing Address
First Line : 6183 PASEO DEL NORTE
Second Line : STE 200
City : CARLSBAD
State : CA
Zip : 92011-1155
Country : US
Telephone Number : 855-259-2288
Fax Number :
Provider Business Practice Location Address
First Line : 3440 OAKWOOD HILLS PKWY
Second Line :
City : EAU CLAIRE
State : WI
Zip : 54701-7698
Country : US
Telephone Number : 715-214-2525
Fax Number :
Authorized Official
Title or Position : VP & SECRETARY
Name : BRIAN PHILLIP FARLEY
Credential :
Telephone Number : 615-861-6000
Provider Enumeration Date : 04/11/2016
Last Update Date : 10/25/2024

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Directions to “MILWAUKEE HEALTH SERVICES SYSTEM, LLC ” Practice Location

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