MEDICARE: COPE BEHAVIORAL SERVICES

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
1	101Y00000X	Counselor

Other Identifiers

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

General Provider Information

NPI Number	:	1952392706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COPE BEHAVIORAL SERVICES

Provider Business Mailing Address
First Line	:	6400 INDUSTRIAL LOOP
Second Line	:
City	:	GREENDALE
State	:	WI
Zip	:	53129-2452
Country	:	US
Telephone Number	:	414-423-4100
Fax Number	:	414-423-4134

Provider Business Practice Location Address
First Line	:	2821 N 4TH ST
Second Line	:	SUITE 121
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-2362
Country	:	US
Telephone Number	:	414-265-5112
Fax Number	:	414-265-4140

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. BALFORD FRANCIS
Credential	:
Telephone Number	:	414-423-4100

Provider Enumeration Date	:	11/01/2005
Last Update Date	:	08/22/2020

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Directions to “COPE BEHAVIORAL SERVICES ” Practice Location

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