ACACIA MENTAL HEALTH (NPI# 1700125622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700125622 |
| Entity Type | Organization |
| Organization Name | ACACIA MENTAL HEALTH |
| Practice Address |
6040 W Lisbon Ave Milwaukee WI 53210-2116 |
| Practice Telephone | 4148719111 |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2013-02-13 |
| Authorized Official Name | LISA JOY STALLMAN (REGISTERED NURSE) |
| Authorized Official Telephone | 4147370280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | 168390-030 | WI | Nursing & Custodial Care Facilities |
| Street Address |
6040 W LISBON AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53210-2116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902869290 | Nancy Hall | Counselor | 6040 W Lisbon Ave, Suite 102, Milwaukee, WI 53210-2116 | 2006-04-08 |
| 1033626338 | Colleen Runge | Counselor | 6040 W Lisbon Ave, Milwaukee, WI 53210-2116 | 2018-01-08 |
| 1043751902 | Rec Enterprise LLC | Case Management | 6040 W Lisbon Ave, Ste B6, Milwaukee, WI 53210-2116 | 2017-03-12 |
| 1437608734 | Active Home Care, LLC | Home Health | 6040 W Lisbon Ave, Suite 104, Milwaukee, WI 53210-2116 | 2016-09-27 |
| 1124475124 | Jessica Bohmann | Counselor | 6040 W Lisbon Ave, Milwaukee, WI 53210-2116 | 2016-05-19 |
| 1609296516 | Ashley Mccoy-rampson Smallwood | Counselor | 6040 W Lisbon Ave, Suite 103, Milwaukee, WI 53210-2116 | 2014-04-17 |
| 1205263159 | Sullivan Medical Clinic, LLC | Internal Medicine | 6040 W Lisbon Ave, Suite 200, Milwaukee, WI 53210-2116 | 2013-10-07 |
| 1033554373 | Our Daily Bread Community Outreach Center, Inc | Case Management | 6040 W Lisbon Ave, Suite 203, Milwaukee, WI 53210-2116 | 2013-04-30 |
| 1164760054 | Terri Lynn Walker | Registered Nurse | 6040 W Lisbon Ave, Suite 102, Milwaukee, WI 53210-2116 | 2013-01-28 |
| 1508101593 | Heidi Weinaug | Counselor | 6040 W Lisbon Ave, Suite 102, Milwaukee, WI 53210-2116 | 2012-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700499514 | Mckenzie Lisa Lambeck | Non-emergency Medical Transport (VAN) | 3016a N 36th St, Milwaukee, WI 53210 | 2020-08-31 |
| 1922572312 | Walter's Second Chance of Milwaukee, LLC. | In Home Supportive Care | 3043 N. 29th Street, Milwaukee, WI 53210 | 2019-01-18 |
| 1407353469 | Angie F Caballero | Assisted Living Facility | 5918 N 62nd Street, Milwaukee, WI 53210 | 2018-04-06 |
| 1689182636 | Kimberly Casey | Counselor | 5325 W.burleigh, Milwaukee, WI 53210 | 2018-01-11 |
| 1336663640 | Daron Mosby | Counselor | 2643 N 55th St., 2643 N 55th St., Milwaukee, WI 53210 | 2017-07-28 |
| 1881117174 | Advance Home Care, LLC | In Home Supportive Care | 6001 W Center St Ste 98ll, Milwaukee, WI 53210 | 2017-07-19 |
| 1285181735 | Aurora Family Services | Clinic/Center | 3200 W. Highland Blvd, Aurora Family Services, Milwaukee, WI 53210 | 2016-09-01 |
| 1447625264 | Kimberly Beckham | Registered Nurse | 3040 N 40th Street, Milwaukee, WI 53210 | 2015-12-04 |
| 1033595319 | Wisconsin Lutheran Child & Family Service Inc. | Social Worker | 207 North Sherman Blvd, Milwaukee, WI 53210 | 2015-08-10 |
| 1346633112 | Quiana Davis | Licensed Practical Nurse | 2478 North 34th Street, Milwaukee, WI 53210 | 2015-03-18 |
| Find all providers in zip 53210 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
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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.