| Inner City Behavior Services, Llc | |
|
4738 W Lisbon Ave Milwaukee WI 53208-2416 | |
| (414) 249-3571 | |
| (414) 249-3876 |
| Full Name | Inner City Behavior Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4738 W Lisbon Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Barbara Tripp (CEO) |
| Authorized Official Contact | 4142493571 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner City Behavior Services, Llc 4738 W Lisbon Ave Ste 8 Milwaukee WI 53208-1127 Ph: (414) 249-3571 | Inner City Behavior Services, Llc 4738 W Lisbon Ave Milwaukee WI 53208-2416 Ph: (414) 249-3571 |
| NPI Number | 1467813956 |
|---|---|
| Provider Enumeration Date | 03/11/2016 |
| Last Update Date | 03/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467813956 | NPI | - | NPPES |
| 1669642591 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 5949-125 (Wisconsin) | Primary |
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