Organization
PREMIER CARE OF WISCONSIN, LLC.
Active
Other names
CMS MILWAUKEE ON CHASE
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX G VILCHIS (CRED MANAGER)
(602) 248-8886
Entity
Organization
Contact information
Practice address
2970 S CHASE AVE # 2974, MILWAUKEE, WI 53207-6407
(414) 905-3100
Mailing address
8444 N 90TH ST STE 100, SCOTTSDALE, AZ 85258-4437
(602) 248-8886
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
05/22/2024
Last updated
09/27/2024
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