MILWAUKEE HEALTH SERVICES SYSTEM, LLC (NPI# 1790837128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790837128 |
| Entity Type | Organization |
| Organization Name | MILWAUKEE HEALTH SERVICES SYSTEM, LLC |
| Other Organization Name | 10TH STREET COMPREHENSIVE TREATMENT CENTER |
| Practice Address |
4800 S. 10th Street Milwaukee WI 53221-2412 |
| Mailing Address |
6185 Paseo Del Norte Ste 150 Carlsbad CA 92011 |
| Practice Telephone | 4147445370 |
| Practice Fax Number | 4147449052 |
| Mailing Telephone | 8552592288 |
| Mailing Fax Number | 7609308923 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2016-04-27 |
| Authorized Official Name | MR. JOHN PELOQUIN (PRESIDENT, CTC DIVISION) |
| Authorized Official Telephone | 7607100951 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | CRC HEALTH GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
1644 | WI | Allopathic & Osteopathic Physicians |
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
1644 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42030200 | 05 |
| Other Name | Type Code |
|---|---|
| 10th Street 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 |
| 1194992404 | Milwaukee Health Services System, LLC | Clinic/Center | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2008-05-15 |
| 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 |
| 1649326737 | Milwaukee Health Services System, LLC | Clinic/Center | 3707 N. Richards Street, Milwaukee, WI 53212-1673 | 2007-01-25 |
| 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 |
4800 S. 10TH STREET |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53221-2412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457815789 | Milwaukee Health Services System, LLC | Clinical Medical Laboratory | 4800 S. 10th Street, Milwaukee, WI 53221-2412 | 2019-01-31 |
| 1871993220 | Roxie Smith | Counselor | 4800 S. 10th Street, Milwaukee, WI 53221 | 2014-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487205944 | Hayat Pharmacy 20 LLC | Pharmacy | 805 W. Layton Ave., Suite B, Milwaukee, WI 53221 | 2019-09-26 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1407343965 | Informe Healthcare LLC | Counselor | 2741 W Layton Ave., Suite 106, Milwaukee, WI 53221 | 2018-04-19 |
| 1447781992 | Itamar Yaakov Gnatt | Emergency Medicine | 2900 W Oklahoma Ave, St Lukes Medical Center, Milwaukee, WI 53221 | 2017-03-27 |
| 1194277160 | Suzanne Derosier | Licensed Practical Nurse | 3910 W Bridge, Greenfield, WI 53221 | 2016-10-26 |
| 1265988117 | Obi Home Care | Clinic/Center | 4439 S 20th St, Milwaukee, WI 53221 | 2016-08-31 |
| 1427430602 | Zezenya Health Care S.c. | Pain Medicine | 5114 S 27th St # 763, Milwaukee, WI 53221 | 2015-06-24 |
| 1851771091 | Feisal J Salahadyn | Counselor | 4800 South 10th Street, Milwaukee, WI 53221 | 2015-06-03 |
| 1114312386 | Holistic Home Health Care Incorporated | Adult Companion | 3422 West Howard Ave, Greenfield, WI 53221 | 2015-04-03 |
| 1841698834 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 5220 S 27th St., Milwaukee, WI 53221 | 2014-12-08 |
| Find all providers in zip 53221 | ||||
| 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 |
|---|---|---|---|---|
| 1740767292 | Ansa Treatment Center Inc | Clinic/Center | 4111 N Port Washington Rd Ste 101a, Milwaukee, WI 53212-1029 | 2018-07-26 |
| 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 |
| 1972980217 | Milwaukee Health Services | Clinic/Center | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2015-05-06 |
| 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 |
| 1265922660 | Addiction Services and Pharmacotherapy, Sc | Clinic/Center | 210 E Olin Ave, Madison, WI 53713-1434 | 2018-05-11 |
| 1003150004 | Ams of Wisconsin, LLC | Clinic/Center | 9532 E 16 Frontage Rd, Suite 100, Onalaska, WI 54650-6739 | 2012-11-15 |
| 1194992404 | Milwaukee Health Services System, LLC | Clinic/Center | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2008-05-15 |
| 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 |
| 1881131761 | Psychological Addiction Services LLC | Clinic/Center | 3113 E Washington Ave, Madison, WI 53704-4330 | 2017-01-30 |
| 1326423534 | Tereo Narcotic Treatment Center, LLC | Clinic/Center | 2405 Northwestern Ave, Suite Lower Level, Racine, WI 53404-2534 | 2015-07-29 |
| 1659522613 | Quality Addiction Management | Clinic/Center | 1610 Miller Park Way, West Milwaukee, WI 53214-3604 | 2008-10-08 |
| Find all providers with the same taxonomy | ||||
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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.