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NPI Code Detail

MEDICARE: MILWAUKEE HEALTH SERVICES, INC

MEDICARE: MILWAUKEE HEALTH SERVICES, INC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)1642WI

General Provider Information

NPI Number : 1356565287
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILWAUKEE HEALTH SERVICES, INC
Provider Business Mailing Address
First Line : 8200 W SILVER SPRING DR
Second Line : ISAAC COGGS HERITAGE HEALTH CENTER
City : MILWAUKEE
State : WI
Zip : 53218-2552
Country : US
Telephone Number : 414-760-3900
Fax Number : 414-760-3983
Provider Business Practice Location Address
First Line : 8200 W SILVER SPRING DR
Second Line : ISAAC COGGS HERITAGE HEALTH CENTER
City : MILWAUKEE
State : WI
Zip : 53218-2552
Country : US
Telephone Number : 414-760-3900
Fax Number : 414-760-3983
Authorized Official
Title or Position : PRESIDENT & CEO
Name : CICERO C HENDERSON III
Credential :
Telephone Number : 414-372-8080
Provider Enumeration Date : 04/12/2007
Last Update Date : 08/22/2020

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