PREMIER CARE OF WISCONSIN, LLC. (NPI# 1356951321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356951321 |
| Entity Type | Organization |
| Organization Name | PREMIER CARE OF WISCONSIN, LLC. |
| Practice Address |
1333 College Ave Ste M1 South Milwaukee WI 53172-1150 |
| Mailing Address |
9449 N 90th St Ste 210 Scottsdale AZ 85258-5037 |
| Practice Telephone | 4147752500 |
| Practice Fax Number | 4143019328 |
| Mailing Telephone | 6022488886 |
| Mailing Fax Number | 6022488999 |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | TODD STINGLEY (CORPORATE CONTROLLER) |
| Authorized Official Telephone | 6022488886 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Community Medical Services- South Milwaukee | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780158261 | Premier Care of Wisconsin, LLC. | Community/Behavioral Health | 2814 S 108th St, West Allis, WI 53227-3224 | 2019-01-17 |
| 1346620952 | Premier Care of Wisconsin, LLC. | Community/Behavioral Health | 23 W Scott St, Fond Du Lac, WI 54935-2342 | 2015-06-09 |
| Street Address |
1333 COLLEGE AVE STE M1 |
| City | SOUTH MILWAUKEE |
| State | WI |
| Zip Code | 53172-1150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952860272 | Aaron J Schricker | Counselor | 827 Milwaukee Ave, South Milwaukee, WI 53172 | 2019-03-16 |
| 1699162883 | Callie Talatzko | Registered Nurse | 1638 Minnesota Ave, South Milwaukee, WI 53172 | 2015-04-25 |
| 1043556756 | Shawna Penelope Vasquez | Occupational Therapist | 1425 Mackinac Ave, Apt # 501, South Milwaukee, WI 53172 | 2012-12-27 |
| 1376840124 | Leah Ann Schmidt | Licensed Practical Nurse | 414 Southtowne Drive, 205, South Milwaukee, WI 53172 | 2011-02-14 |
| 1619164910 | Assisted Living Concepts Inc | Assisted Living Facility | 3829 South Chicago Avenue, South Milwaukee, WI 53172 | 2007-10-01 |
| 1194844134 | Emily Ladich | Nurse Practitioner | 2901 South Chicago Avenue Ste 1, South Milwaukee, WI 53172 | 2007-03-29 |
| 1457477143 | Matthew G Bruins | Occupational Therapist | 3601 S. Chicago Avenue, South Milwaukee, WI 53172 | 2007-03-22 |
| 1134296718 | Ram K Mittal | Surgery | 100 15th Avenue, Suit 170, South Milwaukee, WI 53172 | 2006-11-29 |
| 1689915514 | Wal-mart Stores East Lp | Technician/Technologist | 222 N Chicago Ave, South Milwaukee, WI 53172 | 2013-03-01 |
| 1174799506 | School District of South Milwaukee | Local Education Agency (LEA) | 901 15th Ave, South Milwaukee, WI 53172 | 2008-05-06 |
| Find all providers in zip 53172 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013572353 | Addiction Services and Pharmacotherapy, Sc | Clinic/Center | 11390 W Theo Trekr Way, West Allis, WI 53214-1135 | 2019-05-02 |
| 1740767292 | Ansa Treatment Center Inc | Clinic/Center | 4111 N Port Washington Rd Ste 101a, Milwaukee, WI 53212-1029 | 2018-07-26 |
| 1265922660 | Addiction Services and Pharmacotherapy, Sc | Clinic/Center | 210 E Olin Ave, Madison, WI 53713-1434 | 2018-05-11 |
| 1003150004 | Ams of Wisconsin, LLC | Clinic/Center | 9532 E 16 Frontage Rd, Suite 100, Onalaska, WI 54650-6739 | 2012-11-15 |
| 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 |
| 1174798524 | Milwaukee Health Services System, LLC | Clinic/Center | 4800 S 10th St Unit 1, Milwaukee, WI 53221-2412 | 2008-04-28 |
| 1093912768 | C.o.r.e.,llc | Clinic/Center | 4555 W Schroeder Dr Ste 185, Brown Deer, WI 53223-1494 | 2007-06-27 |
| 1336247139 | Milwaukee Health Services System, LLC | Clinic/Center | 210 Washington St., Wausau, WI 54403-5475 | 2006-09-20 |
| 1881131761 | Psychological Addiction Services LLC | Clinic/Center | 3113 E Washington Ave, Madison, WI 53704-4330 | 2017-01-30 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH MILWAUKEE |
| Zip Code | 53172 |
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| 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.