# LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIFE CHANGING MINISTRIES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1679981328
- **Legal business name:** LIFE CHANGING MINISTRIES
- **Authorized official:** KARINA CHELSKY (PRACTICE MANAGER)
- **Authorized official phone:** (414) 467-8884

## Contact information

- **Practice address:** 1134 W NORTH AVE 2ND FLOOR, MILWAUKEE, WI 53205
- **Practice address phone:** (414) 269-9660
- **Practice address fax:** (414) 755-0698
- **Mailing address:** 1134 W NORTH AVE 2ND FLOOR, MILWAUKEE, WI 53205-1333
- **Mailing address phone:** (414) 269-9660
- **Mailing address fax:** (414) 755-0698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 324500000X | Substance Abuse Rehabilitation Facility | 3045 | WI | — |

## Other

- **Enumeration date:** 07/25/2014
- **Last updated:** 06/16/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100041767 | — | WI |
| 05 | — | 100043806 | — | WI |
| 01 | — | 52D2142323 | FDA CLIA | WI |