RIVER'S SHORE CLINIC (NPI# 1740621044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1740621044 |
Entity Type | Organization |
Organization Name | RIVER'S SHORE CLINIC |
Other Organization Name | CRC HEALTHCARE |
Practice Address |
3707 N Richards St Milwaukee WI 53212-1673 |
Practice Telephone | 4149677006 |
Practice Fax Number | 4149677020 |
Mailing Telephone | 4149677006 |
Mailing Fax Number | 4149677020 |
Enumeration Date | 2013-07-15 |
Last Update Date | 2013-07-15 |
Authorized Official Name | MRS. DEBRA JEAN DANOSKI (CLINIC DIRECTOR) |
Authorized Official Telephone | 4149677006 |
Authorized Official Credential | CSAC, ICS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251S00000X | Community/Behavioral Health | 1643 | WI | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | TAXONOMY NUMBER - 261QM0801X | DJKF54 | 01 |
Other Name | Type Code |
---|---|
CRC Healthcare | Former Legal Business Name - Organization |
Street Address |
3707 N RICHARDS ST |
City | MILWAUKEE |
State | WI |
Zip Code | 53212-1673 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780850594 | Milwaukee Health Services System, LLC | Clinic/Center | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2008-05-01 |
1124626981 | Carolyn Marie Lewis | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-10-14 |
1073120499 | Kathleen Joan St John | Registered Nurse | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-09-29 |
1700404266 | Sheryl Lynn Cotton | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-07-10 |
1477171205 | Carmella L Caceres | Registered Nurse | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-07-08 |
1306471644 | Lea Nickolas | Registered Nurse | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-03-06 |
1366074635 | Michelle Englund | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-02-05 |
1750926531 | A D Venzel Owens | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2019-11-15 |
1205479698 | Natalie Bolton | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2019-10-18 |
1083277057 | Patricia Martin | Licensed Practical Nurse | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2019-04-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609481001 | Beth Leanna | Counselor | Benedict Center 1849 N Dr. Marin Luther King Dr., Suite 101, Milwaukee, WI 53212 | 2020-09-11 |
1326683749 | A.b.d.h. Counseling Services LLC | Clinic/Center | 518 E Concordia Avenue, Milwaukee, WI 53212 | 2019-11-08 |
1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
1386293330 | Rachel Mae Nelson Bagha | Student in an Organized Health Care Education/Training Program | 1849 N Doctor M.l.k. Jr Dr #101, Milwaukee, WI 53212 | 2019-09-11 |
1164085205 | Mary Sue Daase Bowen | Counselor | 2821 N 4th Street, Milwaukee, WI 53212 | 2019-04-15 |
1649733189 | Stacey King | Counselor | Rivershore Comprehensive Treatment Facility, 3703 N Richards St, Milwaukee Wi, Milwaukee, WI 53212 | 2019-04-11 |
1710447701 | Scott William Stauder | Student in an Organized Health Care Education/Training Program | 1121 E. North Ave., Milwaukee, WI 53212 | 2019-03-25 |
1821561168 | Lydia Ann Mendez | Counselor | 3703 N Richards St, Milwaukee, WI 53212 | 2019-01-09 |
1851863302 | Glen Victor Fleming | Counselor | 2821 North 4th Street Suite 210, Milwaukee, WI 53212 | 2018-12-21 |
1093285140 | Megan Marie Volp | Advanced Practice Midwife | 2555 N Doctor M.l.k. Jr Dr, Milwaukee, WI 53212 | 2018-12-03 |
Find all providers in zip 53212 |
Taxonomy Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558968990 | Zoran Jovicic | Community/Behavioral Health | 3239 S 58th St Unit 104, Milwaukee, WI 53219-4365 | 2020-10-08 |
1548816580 | Latara Williams | Community/Behavioral Health | 2447 N 50th St, Milwaukee, WI 53210-2815 | 2019-08-15 |
1942856091 | Kennedy's Circle of Wellness LLC | Community/Behavioral Health | 3614 W North Ave, Milwaukee, WI 53208-1416 | 2019-08-14 |
1205391828 | Jerome Pitchford | Community/Behavioral Health | 1220 W Atkinson Ave, Milwaukee, WI 53206-3024 | 2019-02-07 |
1194233718 | The Evolving Chair Counseling and Consulting Agency | Community/Behavioral Health | 3100 N 78th St, Milwaukee, WI 53222-3916 | 2018-01-17 |
1316453905 | D.a.a.n.i Professional Counseling Service LLC | Community/Behavioral Health | 2943 N 52nd St, Milwaukee, WI 53210-1610 | 2017-12-19 |
1932654845 | The Thresholds | Community/Behavioral Health | 6815 W Capitol Dr # 305, Milwaukee, WI 53216-2070 | 2016-08-20 |
1801341144 | Fly Philanthropy Inc | Community/Behavioral Health | 3352 N Palmer St, Milwaukee, WI 53212-1541 | 2016-08-16 |
1659726545 | Pathway Youth & Famiy Services | Community/Behavioral Health | 3879 N Port Washington Rd, Milwaukee, WI 53212-1180 | 2016-04-27 |
1528413671 | Adventures In Play, LLC | Community/Behavioral Health | 2118 E Kenilworth Pl, Lowr, Milwaukee, WI 53202-1327 | 2016-04-26 |
Find all providers in MILWAUKEE |
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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.