Organization
RIVER'S SHORE CLINIC CTC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAPIKA WASHINGTON MS, CSAC, ICS (CLINICAL DIRECTOR)
(414) 967-7006
Entity
Organization
Contact information
Practice address
3707 N RICHARDS ST, MILWAUKEE, WI 53212-1673
(414) 967-7006
Mailing address
8048 N CELINA ST, MILWAUKEE, WI 53224-2904
(414) 750-6525
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
312890-31
WI
Other
Enumeration date
09/09/2016
Last updated
09/09/2016
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