| Acacia Clinic, Inc. | |
|
6040 W Lisbon Ave Suite 102 Milwaukee WI 53210-2116 | |
| (414) 871-9111 | |
| (414) 871-9121 |
| Full Name | Acacia Clinic, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6040 W Lisbon Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Deidra Lee Kozlowski (PRESIDENT) |
| Authorized Official Contact | 4148719111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Acacia Clinic, Inc. 6040 W Lisbon Ave Suite 102 Milwaukee WI 53210-2116 Ph: (414) 871-9111 | Acacia Clinic, Inc. 6040 W Lisbon Ave Suite 102 Milwaukee WI 53210-2116 Ph: (414) 871-9111 |
| NPI Number | 1417988973 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417988973 | NPI | - | NPPES |
| 42167800 | Medicaid | WI |
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