MILWAUKEE HEALTH SERVICES SYSTEM LLC NPI 1801947965

NPI Information

NPI: 1801947965
Provider Name: MILWAUKEE HEALTH SERVICES SYSTEM, LLC

Doing Business As: MADISON EAST COMPREHENSIVE TREATMENT CENTER

Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

Address:
5109 WORLD DAIRY DR.
MADISON, WI
ZIP 53718
Phone: (608) 242-0220
Get Directions

MILWAUKEE HEALTH SERVICES SYSTEM, LLC is a methadone clinic center in Madison, WI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. MILWAUKEE HEALTH SERVICES SYSTEM, LLC NPI is 1801947965. The provider is registered as an organization entity type.
The provider Is Doing Business As Madison East Comprehensive Treatment Center.

The provider's business location address is:

5109 WORLD DAIRY DR.
MADISON, WI
ZIP 53718-807
Phone: (608) 242-0220
Fax: (608) 242-1166

The provider's authorized official is Brian Phillip Farley .
The authorized official title is Vp & Secretary and has the following contact phone number (615) 861-6000.

The CLIA number assigned to this NPI record is 52D0931324 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 8/11/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	#1549	WISCONSIN	No
2	261QM2800X	Clinic/Center	Methadone	#1549	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	42030300	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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