| Children's Hospital Of Wiscosnin, Inc. | |
|
9000 W Wisconsin Ave Milwaukee WI 53226-4874 | |
| (414) 266-2000 | |
| (414) 266-6219 |
| Full Name | Children's Hospital Of Wiscosnin, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 9000 W Wisconsin Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Timothy L Birkenstock (TREASURER/CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4142666401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Hospital Of Wiscosnin, Inc. Po Box 1997 Milwaukee WI 53201-1997 Ph: (414) 266-2000 | Children's Hospital Of Wiscosnin, Inc. 9000 W Wisconsin Ave Milwaukee WI 53226-4874 Ph: (414) 266-2000 |
| NPI Number | 1053602425 |
|---|---|
| Provider Enumeration Date | 04/20/2011 |
| Last Update Date | 04/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053602425 | NPI | - | NPPES |
| 1750482022 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2417 (Wisconsin) | Primary |
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