| New Vintage Church, Inc. | |
|
6626 W Beloit Rd West Allis WI 53219-2009 | |
| (414) 400-8320 | |
| Not Available |
| Full Name | New Vintage Church, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 6626 W Beloit Rd, West Allis, Wisconsin |
| Authorized Official Name and Position | Kevin Paul Bartelme (SENIOR PASTOR/COUNSELOR) |
| Authorized Official Contact | 4144008320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Vintage Church, Inc. 6626 W Beloit Rd West Allis WI 53219-2009 Ph: (414) 400-8320 | New Vintage Church, Inc. 6626 W Beloit Rd West Allis WI 53219-2009 Ph: (414) 400-8320 |
| NPI Number | 1730898362 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 11/22/2022 |
| Certification Date | 11/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730898362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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