Brotoloc | |
5812 W Burnham St West Allis WI 53219-1524 | |
(414) 543-3200 | |
(414) 543-3269 |
Full Name | Brotoloc |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 5812 W Burnham St, West Allis, Wisconsin |
Authorized Official Name and Position | Douglas Sveda (DIRECTOR) |
Authorized Official Contact | 4145433200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Brotoloc 5812 West Burnham Street West Allis WI 53219 Ph: (414) 543-3200 | Brotoloc 5812 W Burnham St West Allis WI 53219-1524 Ph: (414) 543-3200 |
NPI Number | 1700928017 |
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Provider Enumeration Date | 02/13/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700928017 | NPI | - | NPPES |
42207400 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1114 (Wisconsin) | Primary |
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