Organization · Type 2 NPI

Premier Care of Wisconsin, Llc.

Methadone Clinic · Madison, WI

NPI number 1720701949 Active

Practice location

4802 E Broadway
Madison, WI 53716-4141

Call (608) 889-7500 Map

Fax (480) 687-7361

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.

7 other providers at this address

Other methadone clinic providers in Madison

See all in Madison →

NPI record

NPI: 1720701949
Entity type: Organization (Type 2)
Issued: Sep 22, 2022
Last updated: Feb 10, 2024
Status: Active

Other names

<unavail>
Community Medical Services Madison On Broadway · doing business as
Community Medical Services Madison On Broadway · doing business as

Authorized official

Cindy Gaither
Vice President Revenue Cycle MGMT
(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.

Is this your record? How to update it.

About NPI 1720701949

Premier Care of Wisconsin, Llc.'s National Provider Identifier is 1720701949, issued on Sep 22, 2022. The primary taxonomy on file is Methadone Clinic (261QM2800X), and the practice location is in Madison, WI. The record was last updated on Feb 10, 2024.