| 4th Dimension Recovery Centers | |
|
1216 N Prospect Ave Milwaukee WI 53202-3061 | |
| (973) 277-5359 | |
| (928) 441-1686 |
| Full Name | 4th Dimension Recovery Centers |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 1216 N Prospect Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Jason Lee Luell (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 4144067852 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 4th Dimension Recovery Centers 1216 N Prospect Ave Milwaukee WI 53202-3061 Ph: (973) 277-5359 | 4th Dimension Recovery Centers 1216 N Prospect Ave Milwaukee WI 53202-3061 Ph: (973) 277-5359 |
| NPI Number | 1538634829 |
|---|---|
| Provider Enumeration Date | 10/12/2018 |
| Last Update Date | 10/10/2024 |
| Certification Date | 10/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538634829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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