4TH DIMENSION RECOVERY CENTERS NPI 1538634829

NPI Information

NPI: 1538634829
Provider Name: 4TH DIMENSION RECOVERY CENTERS
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 52D2156861

Address:
1216 N PROSPECT AVE
MILWAUKEE, WI
ZIP 53202
Phone: (973) 277-5359
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4TH DIMENSION RECOVERY CENTERS is a rehabilitation and substance use disorder clinic center in Milwaukee, WI. 4TH DIMENSION RECOVERY CENTERS NPI is 1538634829. The provider is registered as an organization entity type.

The provider's business location address is:

1216 N PROSPECT AVE
MILWAUKEE, WI
ZIP 53202-061
Phone: (973) 277-5359
Fax: (928) 441-1686

The provider's authorized official is Eric Marinelli .
The authorized official title is Account Manager and has the following contact phone number (928) 642-3030.

The CLIA number assigned to this NPI record is 52D2156861 - other - outpatient treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/12/2018 and was last updated on 3/14/2022.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

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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