GRO FAMILY SERVICES LLC NPI 1144475765

NPI Information

NPI: 1144475765
Provider Name: GRO FAMILY SERVICES LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 52D2088778

Address:
6400 W CAPITOL DR
SUITE 200
MILWAUKEE, WI
ZIP 53216
Phone: (414) 445-1400
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GRO FAMILY SERVICES LLC is a mental health (including community mental health center) clinic center in Milwaukee, WI. GRO FAMILY SERVICES LLC NPI is 1144475765. The provider is registered as an organization entity type.

The provider's business location address is:

6400 W CAPITOL DR
SUITE 200
MILWAUKEE, WI
ZIP 53216-156
Phone: (414) 445-1400
Fax: (414) 395-4716

The provider's authorized official is Gregory Renard Owens .
The authorized official title is Ceo and has the following contact phone number (414) 234-1263.

The CLIA number assigned to this NPI record is 52D2088778 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/24/2008 and was last updated on 3/6/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251S00000X	Community/Behavioral Health		2803	WISCONSIN	No
2	324500000X	Substance Abuse Rehabilitation Facility		2803	WISCONSIN	No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	2803	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1144475765	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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