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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
1261QM2800XMethadone Clinic1643WI
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center1643WI

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 : 1780850594
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILWAUKEE HEALTH SERVICES SYSTEM, LLC
Provider Business Mailing Address
First Line : PO BOX 682669
Second Line :
City : FRANKLIN
State : TN
Zip : 37068-2669
Country : US
Telephone Number : 760-710-0819
Fax Number :
Provider Business Practice Location Address
First Line : 3707 N RICHARDS ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-1673
Country : US
Telephone Number : 414-967-7012
Fax Number : 414-967-7020
Authorized Official
Title or Position : VP & SECRETARY
Name : BRIAN PHILLIP FARLEY
Credential :
Telephone Number : 615-861-6000
Provider Enumeration Date : 05/01/2008
Last Update Date : 04/07/2026

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Practice Fax: 414-967-7023
1124343710 — MS. VIRGIL C. JOINER SAC, MSW
Practice Location Address:
3707 N RICHARDS ST
MILWAUKEE, WI
53212-1673
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Practice Location Address:
3707 N RICHARDS ST
MILWAUKEE, WI
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1366720484 — FRED A BOSWELL CSAC, ICS
Practice Location Address:
3707 N RICHARDS ST
MILWAUKEE, WI
53212-1673
Practice Phone: 414-967-7006
Practice Fax: 414-967-7020

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

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