| Omni Enrichment, Incorporation | |
|
3020 W Vliet St Milwaukee WI 53208-2461 | |
| (414) 312-8910 | |
| Not Available |
| Full Name | Omni Enrichment, Incorporation |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3020 W Vliet St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Barbara Ann Tripp (EXECUTIVE DIRECTOR/THERAPIST) |
| Authorized Official Contact | 4143128910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Enrichment, Incorporation 3020 W Vliet St 3897 N. 40th Street Milwaukee WI 53208-2461 Ph: (414) 312-8910 | Omni Enrichment, Incorporation 3020 W Vliet St Milwaukee WI 53208-2461 Ph: (414) 312-8910 |
| NPI Number | 1154574549 |
|---|---|
| Provider Enumeration Date | 10/29/2008 |
| Last Update Date | 02/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154574549 | NPI | - | NPPES |
| 42230300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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