Organization · Type 2 NPI

Waukesha County

Mental Illness Community Based Residential Treatment Facility · Waukesha, WI

NPI number 1477314854 Active

Practice location

1501 Airport Rd
Waukesha, WI 53188-2461

Call (262) 548-7950 Map

Fax (262) 970-6696

Mailing address

514 Riverview Ave
Waukesha, WI 53188-3631

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency	251S00000X	None listed
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	None listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

130 other providers at this address

NPI record

NPI: 1477314854
Entity type: Organization (Type 2)
Issued: Jan 22, 2024
Last updated: Nov 10, 2025
Status: Active

Other names

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Waukesha Co Regional Crisis Stabilization Facility · other name
Waukesha Co Regional Crisis Stabilization Facility · other name

Authorized official

David M Derosier
Credentialing Specialist
(262) 548-8431

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 1477314854

Waukesha County's National Provider Identifier is 1477314854, issued on Jan 22, 2024. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Waukesha, WI. The record was last updated on Nov 10, 2025.