Brotoloc

LBN: Lakeshores Outpatient Clinic
Brotoloc is an health care organization with primary practice located at 3917 47Th Ave , Kenosha WI 53144-1956. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Lakeshores Outpatient Clinic can be contacted via phone (262) 656-9975, or through Barbeaux-Stinson, Melanie via phone (262) 656-9975.

Contact Information

Primary practice address
3917 47Th Ave Kenosha WI 53144-1956
Phone: (262) 656-9975
Fax: (262) 656-9974
Website:
Map and Directions
Authorized official contact:
Name: Barbeaux-Stinson, Melanie Bachelor of Arts (BA)
Phone: (262) 656-9975

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 2605 Wisconsin

Profile Details

NPI number 1629111943
LBN Legal business name Lakeshores Outpatient Clinic
DBA Doing business as Brotoloc
Authorized official Barbeaux-Stinson, Melanie Bachelor of Arts (BA)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 15th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629111943 NPPES
Wisconsin MEDICAID 42242400

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