# PREMIER CARE OF WISCONSIN, LLC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** CMS SOUTH MILWAUKEE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114638806
- **Authorized official:** CINDY GAITHER (VICE PRESIDENT REVENUE CYCLE MGMT)
- **Authorized official phone:** (602) 248-8886

## Contact information

- **Practice address:** 1333 COLLEGE AVE STE M1, SOUTH MILWAUKEE, WI 53172-1150
- **Practice address phone:** (414) 775-2500
- **Practice address fax:** (414) 301-9328
- **Mailing address:** 8444 N 90TH ST STE 100, SCOTTSDALE, AZ 85258-4437
- **Mailing address phone:** (160) 224-8886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM2800X | Methadone Clinic | — | NULL | Yes |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/13/2022
- **Last updated:** 02/10/2024