Willowglen Academy Outpatient Clinic

LBN: Willowglen Academy Inc
Willowglen Academy Outpatient Clinic is an health care organization with primary practice located at 4065 N 35Th St Suite N100, Milwaukee WI 53216-1705. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Willowglen Academy Inc can be contacted via phone (414) 445-9180, or through Maloney, Shanna via phone (414) 445-9180.

Contact Information

Primary practice address
4065 N 35Th St Suite N100 Milwaukee WI 53216-1705
Phone: (414) 445-9180
Fax: (414) 445-5995
Website:
Map and Directions
Authorized official contact:
Name: Maloney, Shanna Licensed Clinical Social Worker (LCSW)
Phone: (414) 445-9180

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 2004 Wisconsin

Profile Details

NPI number 1619147048
LBN Legal business name Willowglen Academy Inc
DBA Doing business as Willowglen Academy Outpatient Clinic
Authorized official Maloney, Shanna Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 29th, 2008
Last updated Jun 19th, 2014 - about 10 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 1619147048 NPPES
Wisconsin MEDICAID 42167200

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