Organization
MAPLEGROVE TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY KABARA LMHP (CENTER DIRECTOR)
(262) 510-4447
Entity
Organization
Contact information
Practice address
1455 S 97TH ST, WEST ALLIS, WI 53214-4133
(262) 510-4447
Mailing address
1455 S 97TH ST, WEST ALLIS, WI 53214-4133
(262) 510-4447
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3026
WI
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
128973
WI
222Q00000X
Developmental Therapist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
WI
Other
Enumeration date
03/07/2014
Last updated
04/11/2014
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