Lakeshore Clinic Ltd
Clinic/Center, Mental Health (Including Community Mental Health Center) in Milwaukee, WI. Organization (NPI-2).
Details
- NPI
- 1407925985
- Entity type
- Organization (NPI-2)
- Legal business name
- Lakeshore Clinic Ltd
- Organization subpart
- No
- Enumeration date
- Nov 7, 2006
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | 1497 | WI | Yes |
Practice location
3970 N Oakland AveSuite 502
Milwaukee, WI 53211
Phone 414-962-9909 · Fax 414-332-8596
Mailing address
3970 N Oakland AveSuite 502
Milwaukee, WI 53211
Phone 414-962-9909 · Fax 414-332-8596
Authorized official
Patricia K Briceno
Administrator
4149629909
Is something wrong?
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