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SHALEM HEALING INC. NPI 1073801395


NPI Information

NPI: 1073801395
Provider Name: SHALEM HEALING, INC.
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 52D1052772

Address:
3338 N DOCTOR MARTIN LUTHER KING JR. DRIVE
MILWAUKEE, WI
ZIP 53212
Phone: (414) 640-5433
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SHALEM HEALING, INC. is a clinic center in Milwaukee, WI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SHALEM HEALING, INC. NPI is 1073801395. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3338 N DOCTOR MARTIN LUTHER KING JR. DRIVE
MILWAUKEE, WI
ZIP 53212
Phone: (414) 640-5433

The provider's authorized official is Jonathan Gelfman .
The authorized official title is Clinic Director and has the following contact phone number (414) 640-5433.

The CLIA number assigned to this NPI record is 52D1052772 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2011 and was last updated on 12/6/2023.


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
1225X00000XOccupational TherapistNo
2363LF0000XNurse PractitionerFamilyNo
3363LP0200XNurse PractitionerPediatricsNo
4363LP2300XNurse PractitionerPrimary CareNo
5261Q00000XClinic/CenterYes

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
139909600MEDICAIDWISCONSIN

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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