| Social Rehabilitation And Residential Resources, Inc. | |
|
9330 W Lincoln Ave Ste 21 West Allis WI 53227-2300 | |
| (414) 546-6880 | |
| (414) 546-6234 |
| Full Name | Social Rehabilitation And Residential Resources, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9330 W Lincoln Ave Ste 21, West Allis, Wisconsin |
| Authorized Official Name and Position | Jeffery Kincaid (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4145466880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Social Rehabilitation And Residential Resources, Inc. 9330 W Lincoln Ave Ste 21 West Allis WI 53227-2300 Ph: (414) 546-6880 | Social Rehabilitation And Residential Resources, Inc. 9330 W Lincoln Ave Ste 21 West Allis WI 53227-2300 Ph: (414) 546-6880 |
| NPI Number | 1154514776 |
|---|---|
| Provider Enumeration Date | 08/27/2007 |
| Last Update Date | 08/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154514776 | NPI | - | NPPES |
| 42242500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2611 (Wisconsin) | Primary |
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