Organization · Type 2 NPI

Premier Care of Wisconsin, Llc.

Methadone Clinic · Pewaukee, WI

NPI number 1215644356 Active

Practice location

1611 Silvernail Road
Pewaukee, WI 53072-5519

Call (262) 304-0150 Map

Fax (262) 933-4244

Mailing address

8444 N 90th St Ste 100
Scottsdale, AZ 85258-4437

Specialties and licenses

Taxonomy	Code	License
Addiction (Substance Use Disorder) Counselor	101YA0400X	None listed
Community/Behavioral Health Agency	251S00000X	None listed
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed
Methadone Clinic Primary	261QM2800X	None listed
Substance Use Disorder Rehabilitation Clinic/Center	261QR0405X	None listed

Methadone Clinic: An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

NPI record

NPI: 1215644356
Entity type: Organization (Type 2)
Issued: Oct 28, 2022
Last updated: Sep 3, 2024
Status: Active

Other names

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Community Medical Services Pewaukee · doing business as
Community Medical Services Pewaukee · doing business as

Authorized official

Cindy Gaither
VP of Revenue Cycle Management
(602) 248-8886

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1215644356

Premier Care of Wisconsin, Llc.'s National Provider Identifier is 1215644356, issued on Oct 28, 2022. The primary taxonomy on file is Methadone Clinic (261QM2800X), and the practice location is in Pewaukee, WI. The record was last updated on Sep 3, 2024.