LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES


Address: 1134 W North Ave 2nd Floor, Milwaukee, WI 53205
Phone: 4142699660

LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES (NPI# 1679981328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679981328
Entity Type Organization
Organization Name LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES
Practice Address 1134 W North Ave 2nd Floor
Milwaukee
WI 53205
Mailing Address 1134 W North Ave 2nd Floor
Milwaukee
WI 53205-1333
Practice Telephone 4142699660
Practice Fax Number 4147550698
Mailing Telephone 4142699660
Mailing Fax Number 4147550698
Enumeration Date 2014-07-25
Last Update Date 2018-06-16
Authorized Official Name KARINA CHELSKY (PRACTICE MANAGER)
Authorized Official Telephone 4144678884
Is Organization Subpart Y
Parent Organization Name LIFE CHANGING MINISTRIES

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities
N 324500000X Substance Abuse Rehabilitation Facility 3045 WI Residential Treatment Facilities
Y 261Q00000X Clinic/Center Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
WI 100041767 05
WI FDA CLIA 52D2142323 01
WI 100043806 05

Office Location

Street Address 1134 W NORTH AVE 2ND FLOOR
City MILWAUKEE
State WI
Zip Code 53205

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1891031969 Robin Michelle Benjamin Licensed Practical Nurse 1536 N 20th, Mil., WI 53205 2012-12-18
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194337212 Accident and Injury Rehab Center, Inc Clinic/Center 6114 W Capitol Dr Ste 100-102, Milwaukee, WI 53216-2147 2020-08-19
1326683749 A.b.d.h. Counseling Services LLC Clinic/Center 518 E Concordia Avenue, Milwaukee, WI 53212 2019-11-08
1154889749 Positive Directions Inc Clinic/Center 3510 W Saint Paul Ave # 6, Milwaukee, WI 53208-4125 2019-03-04
1255844106 Comprehensive Diagnostic Imaging of Wisconsin, LLC Clinic/Center 2500 W Layton Ave Ste 20, Milwaukee, WI 53221-5400 2017-11-14
1265980767 Wisconsin Healthcare Services Clinic/Center 2462 West Lisbon Avenue, Milwaukee, WI 53205 2016-09-14
1861859902 Wisconsin Healthcare Network LLC Clinic/Center 5600 W Brown Deer Rd Ste 228, Milwaukee, WI 53223-2311 2016-01-20
1801229653 Sixteen Street Community Health Center Clinic/Center 1337 S Cesar E Chavez Dr, Milwaukee, WI 53204-2712 2013-08-15
1821333550 Milwaukee Spine and Joint Center Clinic/Center 1631 W Lincoln Ave, Milwaukee, WI 53215-2637 2012-12-06
1003175316 Healing Center of Milwaukee Clinic/Center 5800 W Forest Home Ave, Milwaukee, WI 53220-1954 2012-05-07
1437472172 Physician Associates of Wisconsin, Sc Clinic/Center 7033 Wellauer Dr, Milwaukee, WI 53213-3734 2010-03-09
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Competitor

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City MILWAUKEE
Zip Code 53205

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Dataset Information

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.

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