| Gerald L. Ignace Indian Health Center, Inc. | |
|
930 W Historic Mitchell St Milwaukee WI 53204-3533 | |
| (414) 383-9526 | |
| (414) 389-3881 |
| Full Name | Gerald L. Ignace Indian Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 930 W Historic Mitchell St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Lyle A Ignace (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4143839526 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerald L. Ignace Indian Health Center, Inc. 930 W Historic Mitchell St Milwaukee WI 53204-3533 Ph: (414) 383-9526 | Gerald L. Ignace Indian Health Center, Inc. 930 W Historic Mitchell St Milwaukee WI 53204-3533 Ph: (414) 383-9526 |
| NPI Number | 1447657739 |
|---|---|
| Provider Enumeration Date | 12/02/2014 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447657739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 3040 (Wisconsin) | Primary |
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