MILWAUKEE HEALTH SERVICES SYSTEM, LLC (NPI# 1174798524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174798524 |
| Entity Type | Organization |
| Organization Name | MILWAUKEE HEALTH SERVICES SYSTEM, LLC |
| Other Organization Name | 10TH STREET COMPREHENSIVE TREATMENT CENTER |
| Practice Address |
4800 S 10th St Unit 1 Milwaukee WI 53221-2412 |
| Practice Telephone | 4147445370 |
| Practice Fax Number | 4147449052 |
| Mailing Telephone | 4147445370 |
| Mailing Fax Number | 4147449052 |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2016-06-13 |
| Authorized Official Name | MR. JOHN PELOQUIN (PRESIDENT, CTC DIVISION) |
| Authorized Official Telephone | 8552592288 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | CRC HEALTH GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
1644 | WI | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | UPIN | E5700183 | 01 |
| WI | 42225700 | 05 |
| Other Name | Type Code |
|---|---|
| 10th Street Comprehensive Treatment Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881942845 | Milwaukee Health Services System, LLC | Clinic/Center | 210 Washington Street, Wausau, WI 54403-5475 | 2012-08-24 |
| 1194992404 | Milwaukee Health Services System, LLC | Clinic/Center | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2008-05-15 |
| 1780850594 | Milwaukee Health Services System, LLC | Clinic/Center | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2008-05-01 |
| 1649326737 | Milwaukee Health Services System, LLC | Clinic/Center | 3707 N. Richards Street, Milwaukee, WI 53212-1673 | 2007-01-25 |
| 1790837128 | Milwaukee Health Services System, LLC | Psychiatry & Neurology | 4800 S. 10th Street, Milwaukee, WI 53221-2412 | 2007-01-17 |
| 1467503193 | Milwaukee Health Services System, LLC | Counselor | 3301 N. Ballard Road, Ste. B, Appleton, WI 54911-8928 | 2007-01-16 |
| 1801947965 | Milwaukee Health Services System, LLC | Clinic/Center | 5109 World Dairy Dr., Madison, WI 53718-3807 | 2007-01-16 |
| 1336247139 | Milwaukee Health Services System, LLC | Clinic/Center | 210 Washington St., Wausau, WI 54403-5475 | 2006-09-20 |
| 1457815789 | Milwaukee Health Services System, LLC | Clinical Medical Laboratory | 4800 S. 10th Street, Milwaukee, WI 53221-2412 | 2019-01-31 |
| 1144684697 | Milwaukee Health Services System, LLC | Counselor | 3440 Oakwood Hills Pkwy, Eau Claire, WI 54701-7698 | 2016-04-11 |
| Street Address |
4800 S 10TH ST UNIT 1 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53221-2412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306363718 | Debra Fenceroy | Registered Nurse | 4800 S 10th St Unit 1, Milwaukee, WI 53221-2412 | 2017-08-25 |
| 1063855914 | Patricia Marie Brunette | Registered Nurse | 4800 S 10th St Unit 1, Milwaukee, WI 53221-2412 | 2013-04-10 |
| 1407104532 | Sonia Dell Rienecker | Counselor | 4800 S 10th St Unit 1, Milwaukee, WI 53221-2412 | 2012-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487205944 | Hayat Pharmacy 20 LLC | Pharmacy | 805 W. Layton Ave., Suite B, Milwaukee, WI 53221 | 2019-09-26 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1407343965 | Informe Healthcare LLC | Counselor | 2741 W Layton Ave., Suite 106, Milwaukee, WI 53221 | 2018-04-19 |
| 1447781992 | Itamar Yaakov Gnatt | Emergency Medicine | 2900 W Oklahoma Ave, St Lukes Medical Center, Milwaukee, WI 53221 | 2017-03-27 |
| 1194277160 | Suzanne Derosier | Licensed Practical Nurse | 3910 W Bridge, Greenfield, WI 53221 | 2016-10-26 |
| 1265988117 | Obi Home Care | Clinic/Center | 4439 S 20th St, Milwaukee, WI 53221 | 2016-08-31 |
| 1427430602 | Zezenya Health Care S.c. | Pain Medicine | 5114 S 27th St # 763, Milwaukee, WI 53221 | 2015-06-24 |
| 1851771091 | Feisal J Salahadyn | Counselor | 4800 South 10th Street, Milwaukee, WI 53221 | 2015-06-03 |
| 1114312386 | Holistic Home Health Care Incorporated | Adult Companion | 3422 West Howard Ave, Greenfield, WI 53221 | 2015-04-03 |
| 1841698834 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 5220 S 27th St., Milwaukee, WI 53221 | 2014-12-08 |
| Find all providers in zip 53221 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316587439 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 1635 W National Ave, Milwaukee, WI 53204-1130 | 2020-01-07 |
| 1689149700 | Birt Supportive Services LLC | Clinic/Center | 4868 N 89th St, Milwaukee, WI 53225-4106 | 2018-10-04 |
| 1285181735 | Aurora Family Services | Clinic/Center | 3200 W. Highland Blvd, Aurora Family Services, Milwaukee, WI 53210 | 2016-09-01 |
| 1679981328 | Life Changing Ministries Substance Abuse Services | Clinic/Center | 1134 W North Ave 2nd Floor, Milwaukee, WI 53205 | 2014-07-25 |
| 1962839589 | Shoreview Counseling Services | Clinic/Center | 4950 N 21st St, Lower Level, Milwaukee, WI 53209-5750 | 2013-09-27 |
| 1952608721 | Community Advocates, Inc | Clinic/Center | 4906 W Fond Du Lac Ave, Milwaukee, WI 53216-2325 | 2011-02-14 |
| 1841438769 | Counseling & Transition Center Inc | Clinic/Center | 3073 S. Chase Ave, Suite 326, Milwaukee, WI 53207 | 2009-01-30 |
| 1639193212 | Horizon Healthcare, Inc | Clinic/Center | 5408 W Burleigh St, Milwaukee, WI 53210-1624 | 2006-07-27 |
| 1053934034 | Heather Hart Kennedy, Lcsw, LLC | Clinic/Center | 1110 N Old World 3rd St Ste 401, Milwaukee, WI 53203-1117 | 2020-05-25 |
| 1033772058 | Different Shades of Healing, LLC | Clinic/Center | 6830 W Villard Ave Ste 190, Milwaukee, WI 53218-3968 | 2019-04-16 |
| Find all providers in MILWAUKEE | ||||
Please comment or provide details below to improve the information on MILWAUKEE HEALTH SERVICES SYSTEM, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.