Organization
WAUKESHA COUNTY
Active
Other names
Waukesha Co Regional Crisis Stabilization Facility
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M DEROSIER (CREDENTIALING SPECIALIST)
(262) 548-8431
Entity
Organization
Contact information
Practice address
1501 AIRPORT RD, WAUKESHA, WI 53188-2461
(262) 548-7950
(262) 970-6696
Mailing address
514 RIVERVIEW AVE, WAUKESHA, WI 53188-3631
(262) 548-7666
(262) 970-6696
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019880
LICENSE NUMBER
WI
Enumeration date
01/22/2024
Last updated
11/10/2025
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