Organization
4TH DIMENSION RECOVERY CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON LEE LUELL (CHIEF OPERATIONS OFFICER)
(414) 406-7852
Entity
Organization
Contact information
Practice address
1216 N PROSPECT AVE, MILWAUKEE, WI 53202-3061
(973) 277-5359
(928) 441-1686
Mailing address
1216 N PROSPECT AVE, MILWAUKEE, WI 53202-3061
(973) 277-5359
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2018
Last updated
10/10/2024
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