| Thresholds | |
|
6815 W Capitol Dr # 305 Milwaukee WI 53216-2070 | |
| (773) 572-5147 | |
| Not Available |
| Full Name | Thresholds |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6815 W Capitol Dr # 305, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Mark Ishaug (CEO) |
| Authorized Official Contact | 7735725500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thresholds 4101 N Ravenswood Ave Chicago IL 60613-2193 Ph: (773) 572-5500 | Thresholds 6815 W Capitol Dr # 305 Milwaukee WI 53216-2070 Ph: (773) 572-5147 |
| NPI Number | 1932654845 |
|---|---|
| Provider Enumeration Date | 08/20/2016 |
| Last Update Date | 08/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932654845 | NPI | - | NPPES |
| 04133 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 04133 (Illinois) | Primary |
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