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LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES NPI 1679981328


NPI Information

NPI: 1679981328
Provider Name: LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1134 W NORTH AVE 2ND FLOOR
MILWAUKEE, WI
ZIP 53205
Phone: (414) 269-9660
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LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES 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). LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES NPI is 1679981328. The provider is registered as an organization entity type.

The provider's business location address is:

1134 W NORTH AVE 2ND FLOOR
MILWAUKEE, WI
ZIP 53205
Phone: (414) 269-9660
Fax: (414) 755-0698

The provider's authorized official is Karina Chelsky .
The authorized official title is Practice Manager and has the following contact phone number (414) 467-8884.

The enumeration date for this NPI number is 7/25/2014 and was last updated on 6/16/2018.


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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2324500000XSubstance Abuse Rehabilitation Facility3045WISCONSINNo
3261Q00000XClinic/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
1100043806MEDICAIDWISCONSIN
2100041767MEDICAIDWISCONSIN
352D2142323OTHERWISCONSINFDA CLIA

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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