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RIVER'S SHORE CLINIC NPI 1740621044


NPI Information

NPI: 1740621044
Provider Name: RIVER'S SHORE CLINIC

Former Legal Business Name: CRC HEALTHCARE

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
3707 N RICHARDS ST
MILWAUKEE, WI
ZIP 53212
Phone: (414) 967-7006
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RIVER'S SHORE CLINIC is a community behavioral health in Milwaukee, WI. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. RIVER'S SHORE CLINIC NPI is 1740621044. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Crc Healthcare.

The provider's business location address is:

3707 N RICHARDS ST
MILWAUKEE, WI
ZIP 53212-673
Phone: (414) 967-7006
Fax: (414) 967-7020

The provider's authorized official is Debra Jean Danoski .
The authorized official title is Clinic Director and has the following contact phone number (414) 967-7006.

The enumeration date for this NPI number is 7/15/2013 and was last updated on 7/15/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral Health1643WISCONSINYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DJKF54OTHERWISCONSINTAXONOMY NUMBER - 261QM0801X

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

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