MILWAUKEE HEALTH SERVICES SYSTEM, LLC (NPI# 1194992404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194992404 |
Entity Type | Organization |
Organization Name | MILWAUKEE HEALTH SERVICES SYSTEM, LLC |
Other Organization Name | MADISON EAST COMPREHENSIVE TREATMENT CENTER |
Practice Address |
5109 World Dairy Dr Madison WI 53718-3807 |
Practice Telephone | 6082420220 |
Practice Fax Number | 6082421166 |
Mailing Telephone | 6082420220 |
Mailing Fax Number | 6082421166 |
Enumeration Date | 2008-05-15 |
Last Update Date | 2016-05-20 |
Authorized Official Name | MR. JOHN PELOQUIN (PRESIDENT, CTC DIVISION) |
Authorized Official Telephone | 8552592288 |
Authorized Official Credential | PHD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 42225600 | 05 |
Other Name | Type Code |
---|---|
Madison East Comprehensive Treatment Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881942845 | Milwaukee Health Services System, LLC | Clinic/Center | 210 Washington Street, Wausau, WI 54403-5475 | 2012-08-24 |
1780850594 | Milwaukee Health Services System, LLC | Clinic/Center | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2008-05-01 |
1174798524 | Milwaukee Health Services System, LLC | Clinic/Center | 4800 S 10th St Unit 1, Milwaukee, WI 53221-2412 | 2008-04-28 |
1649326737 | Milwaukee Health Services System, LLC | Clinic/Center | 3707 N. Richards Street, Milwaukee, WI 53212-1673 | 2007-01-25 |
1790837128 | Milwaukee Health Services System, LLC | Psychiatry & Neurology | 4800 S. 10th Street, Milwaukee, WI 53221-2412 | 2007-01-17 |
1467503193 | Milwaukee Health Services System, LLC | Counselor | 3301 N. Ballard Road, Ste. B, Appleton, WI 54911-8928 | 2007-01-16 |
1801947965 | Milwaukee Health Services System, LLC | Clinic/Center | 5109 World Dairy Dr., Madison, WI 53718-3807 | 2007-01-16 |
1336247139 | Milwaukee Health Services System, LLC | Clinic/Center | 210 Washington St., Wausau, WI 54403-5475 | 2006-09-20 |
1457815789 | Milwaukee Health Services System, LLC | Clinical Medical Laboratory | 4800 S. 10th Street, Milwaukee, WI 53221-2412 | 2019-01-31 |
1144684697 | Milwaukee Health Services System, LLC | Counselor | 3440 Oakwood Hills Pkwy, Eau Claire, WI 54701-7698 | 2016-04-11 |
Street Address |
5109 WORLD DAIRY DR |
City | MADISON |
State | WI |
Zip Code | 53718-3807 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255947313 | Jackie L Moretti | Counselor | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2020-09-23 |
1508487695 | Bethany Marie Shoemaker | Counselor | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2020-04-30 |
1013547793 | Janine L Williams | Counselor | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2020-01-22 |
1306476403 | Amy E Zellman | Counselor | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2020-01-17 |
1588200125 | Keith E Hampton | Counselor | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2019-11-19 |
1669021085 | Brian D Cook | Counselor | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2019-09-09 |
1588218861 | Dennis R Elmergreen | Counselor | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2019-07-25 |
1689233439 | August Michael Viegut II | Counselor | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2019-06-06 |
1316405731 | Linda Lee Richardson | Registered Nurse | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2019-03-05 |
1043781834 | Sarbjit K Mavi | Registered Nurse | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2018-12-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609475607 | Suchart Thammahong | Pharmacist | 734 Mclean Drive, Madison, Wi, WI 53718 | 2020-10-21 |
1780033431 | Elizabeth C Armstrong | Registered Nurse | 2810 Crossroads Dr Ste 4000, Madison, WI 53718 | 2016-06-03 |
1811356926 | Quirt Family Dentistry, Sc | Dentist | 6038 Gemini Drive, Madison, WI 53718 | 2016-02-17 |
1831583145 | Madison Rehabilitation Hospital, LLC | Rehabilitation Hospital | 5115 N Biltmore Ln, Madison, WI 53718 | 2015-03-25 |
1972919959 | Hannah E Kussler | Physician Assistant | The American Center, 4602 Eastpark Blvd, Madison, WI 53718 | 2014-07-10 |
1104187079 | Kaitlin Hellenbrand | Occupational Therapist | 5249 East Terrace Drive, Madison, WI 53718 | 2012-06-06 |
1003172800 | Wisconsin Hyperbaric Oxygen LLC | Clinic/Center | 4660 S Biltmore Lane, Madison, WI 53718 | 2012-04-05 |
1801022850 | Justin Robert Bangert | Marriage & Family Therapist | 5310 Wall St., Ste #500, Madison, WI 53718 | 2009-06-04 |
1427292275 | Jane Louise Stroede | Physical Therapy Assistant | 2802 Walton Commons West, Madison, WI 53718 | 2009-04-23 |
1003060658 | Candace Leigh Pantoga | Occupational Therapist | 3030 City View Drive, City View Nursing Home, Madison, WI 53718 | 2008-11-10 |
Find all providers in zip 53718 |
Taxonomy Code | 261QM2800X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Methadone Clinic |
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265922660 | Addiction Services and Pharmacotherapy, Sc | Clinic/Center | 210 E Olin Ave, Madison, WI 53713-1434 | 2018-05-11 |
1881131761 | Psychological Addiction Services LLC | Clinic/Center | 3113 E Washington Ave, Madison, WI 53704-4330 | 2017-01-30 |
1477605335 | Madison Health Services | Clinic/Center | 5109 World Dairy Dr., Madison, WI 53718 | 2007-01-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356951321 | Premier Care of Wisconsin, LLC. | Clinic/Center | 1333 College Ave Ste M1, South Milwaukee, WI 53172-1150 | 2020-08-05 |
1013572353 | Addiction Services and Pharmacotherapy, Sc | Clinic/Center | 11390 W Theo Trekr Way, West Allis, WI 53214-1135 | 2019-05-02 |
1740767292 | Ansa Treatment Center Inc | Clinic/Center | 4111 N Port Washington Rd Ste 101a, Milwaukee, WI 53212-1029 | 2018-07-26 |
1003150004 | Ams of Wisconsin, LLC | Clinic/Center | 9532 E 16 Frontage Rd, Suite 100, Onalaska, WI 54650-6739 | 2012-11-15 |
1780850594 | Milwaukee Health Services System, LLC | Clinic/Center | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2008-05-01 |
1174798524 | Milwaukee Health Services System, LLC | Clinic/Center | 4800 S 10th St Unit 1, Milwaukee, WI 53221-2412 | 2008-04-28 |
1093912768 | C.o.r.e.,llc | Clinic/Center | 4555 W Schroeder Dr Ste 185, Brown Deer, WI 53223-1494 | 2007-06-27 |
1336247139 | Milwaukee Health Services System, LLC | Clinic/Center | 210 Washington St., Wausau, WI 54403-5475 | 2006-09-20 |
1326423534 | Tereo Narcotic Treatment Center, LLC | Clinic/Center | 2405 Northwestern Ave, Suite Lower Level, Racine, WI 53404-2534 | 2015-07-29 |
1972980217 | Milwaukee Health Services | Clinic/Center | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2015-05-06 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.