RIVER'S SHORE CLINIC CTC (NPI# 1285187179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285187179 |
| Entity Type | Organization |
| Organization Name | RIVER'S SHORE CLINIC CTC |
| Practice Address |
3707 N Richards St Milwaukee WI 53212-1673 |
| Practice Telephone | 4149677006 |
| Mailing Telephone | 4149677006 |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-07-27 |
| Authorized Official Name | LATEKA WASHINGTON (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 4149677006 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 227113 | WI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100056280 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093262891 | River's Shore Clinic Ctc | Health Maintenance Organization | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2016-09-09 |
| Street Address |
3707 N RICHARDS ST |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53212-1673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780850594 | Milwaukee Health Services System, LLC | Clinic/Center | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2008-05-01 |
| 1124626981 | Carolyn Marie Lewis | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-10-14 |
| 1073120499 | Kathleen Joan St John | Registered Nurse | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-09-29 |
| 1700404266 | Sheryl Lynn Cotton | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-07-10 |
| 1477171205 | Carmella L Caceres | Registered Nurse | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-07-08 |
| 1306471644 | Lea Nickolas | Registered Nurse | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-03-06 |
| 1366074635 | Michelle Englund | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2020-02-05 |
| 1750926531 | A D Venzel Owens | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2019-11-15 |
| 1205479698 | Natalie Bolton | Counselor | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2019-10-18 |
| 1083277057 | Patricia Martin | Licensed Practical Nurse | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2019-04-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481001 | Beth Leanna | Counselor | Benedict Center 1849 N Dr. Marin Luther King Dr., Suite 101, Milwaukee, WI 53212 | 2020-09-11 |
| 1326683749 | A.b.d.h. Counseling Services LLC | Clinic/Center | 518 E Concordia Avenue, Milwaukee, WI 53212 | 2019-11-08 |
| 1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
| 1386293330 | Rachel Mae Nelson Bagha | Student in an Organized Health Care Education/Training Program | 1849 N Doctor M.l.k. Jr Dr #101, Milwaukee, WI 53212 | 2019-09-11 |
| 1164085205 | Mary Sue Daase Bowen | Counselor | 2821 N 4th Street, Milwaukee, WI 53212 | 2019-04-15 |
| 1649733189 | Stacey King | Counselor | Rivershore Comprehensive Treatment Facility, 3703 N Richards St, Milwaukee Wi, Milwaukee, WI 53212 | 2019-04-11 |
| 1710447701 | Scott William Stauder | Student in an Organized Health Care Education/Training Program | 1121 E. North Ave., Milwaukee, WI 53212 | 2019-03-25 |
| 1821561168 | Lydia Ann Mendez | Counselor | 3703 N Richards St, Milwaukee, WI 53212 | 2019-01-09 |
| 1851863302 | Glen Victor Fleming | Counselor | 2821 North 4th Street Suite 210, Milwaukee, WI 53212 | 2018-12-21 |
| 1093285140 | Megan Marie Volp | Advanced Practice Midwife | 2555 N Doctor M.l.k. Jr Dr, Milwaukee, WI 53212 | 2018-12-03 |
| Find all providers in zip 53212 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740589084 | Harambee Ombudsman Project Inc. | Substance Abuse Rehabilitation Facility | 335 W Wright St, Milwaukee, WI 53212-2729 | 2011-03-25 |
| 1790088896 | Meta House | Substance Abuse Rehabilitation Facility | 2618 N Bremen St, Milwaukee, WI 53212-3003 | 2010-12-10 |
| 1821326455 | Whites Residential Treatment & Clinical Services, Inc. | Substance Abuse Rehabilitation Facility | 4020 W Burleigh St, Milwaukee, WI 53210-1817 | 2009-11-19 |
| 1467609776 | United Community Center | Substance Abuse Rehabilitation Facility | 1111 S 6th St, Milwaukee, WI 53204-2301 | 2008-08-19 |
| 1639244254 | Horizon Inc | Substance Abuse Rehabilitation Facility | 2511 West Vine Street, Milwaukee, WI 53205 | 2006-11-21 |
| 1124482229 | Shecar Substance Abuse/mental Health Clinic | Substance Abuse Rehabilitation Facility | 2821 N 4th St, Milwaukee, WI 53212-2362 | 2016-04-05 |
| 1003217423 | Kenneth Santana | Substance Abuse Rehabilitation Facility | 1111 S 6th St, Milwaukee, WI 53204-2301 | 2014-09-05 |
| 1063759306 | United Community Center | Substance Abuse Rehabilitation Facility | 1028 S 9th St, Milwaukee, WI 53204-1335 | 2013-01-07 |
| 1386943066 | Community Care Housing LLC | Substance Abuse Rehabilitation Facility | 544 E Ogden Ave, Ste 700-268, Milwaukee, WI 53202-2698 | 2011-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114415908 | Iris Health Clinic LLC | Substance Abuse Rehabilitation Facility | 260 S Elm Grove Rd, Brookfield, WI 53005-6522 | 2018-04-26 |
| 1396259420 | Whole Life Services LLC | Substance Abuse Rehabilitation Facility | 819 Ash St Ste 150, Spooner, WI 54801-1201 | 2017-11-28 |
| 1306298740 | Phoenix Counseling | Substance Abuse Rehabilitation Facility | 64 S 4th St, Barron, WI 54812-1503 | 2016-07-11 |
| 1043684251 | Millenium Manor, LLC | Substance Abuse Rehabilitation Facility | 4509 Arthur Rd, Slinger, WI 53086-9603 | 2015-11-25 |
| 1780081174 | Psthways To A Better Life 1, LLC | Substance Abuse Rehabilitation Facility | 13111 Lax Chapel Rd, Kiel, WI 53042-3954 | 2014-12-01 |
| 1710304878 | Exodus Transitional Care Facility Inc. | Substance Abuse Rehabilitation Facility | 1421 Fond Du Lac Ave, Kewaskum, WI 53040-9136 | 2014-03-26 |
| 1558798686 | Friends of Women In Recovery Inc. | Substance Abuse Rehabilitation Facility | 166 S Park Ave, Fond Du Lac, WI 54935-4441 | 2013-10-03 |
| 1457784662 | The Pines Treatment & Recovery Center | Substance Abuse Rehabilitation Facility | N3387 State Road 73, Wautoma, WI 54982-5257 | 2013-08-12 |
| 1215375472 | Hope Haven | Substance Abuse Rehabilitation Facility | 3602 Memorial Dr, Madison, WI 53704-1106 | 2013-06-10 |
| 1831464536 | Alcocare Inc. | Substance Abuse Rehabilitation Facility | 786 S Main St, Janesville, WI 53545-4852 | 2012-03-13 |
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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.