River'S Shore Clinic Ctc

LBN: River'S Shore Clinic Ctc
River'S Shore Clinic Ctc is an health care organization with primary practice located at 3707 N Richards St , Milwaukee WI 53212-1673. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty. River'S Shore Clinic Ctc can be contacted via phone (414) 967-7006, or through Washington, Lateka via phone (414) 967-7006.

Contact Information

Primary practice address
3707 N Richards St Milwaukee WI 53212-1673
Phone: (414) 967-7006
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Washington, Lateka
Phone: (414) 967-7006

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X 227113 Wisconsin

Profile Details

NPI number 1285187179
LBN Legal business name River'S Shore Clinic Ctc
DBA Doing business as
Authorized official Washington, Lateka
Entity Organization
Organization subpart 1 No
Enumeration date Jul 27th, 2016
Last updated Jul 27th, 2016 - about 9 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 1285187179 NPPES
Wisconsin MEDICAID 100056280

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