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Organization

BCS OF WISCONSIN S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT ARTHUR CLEMENTE (ADMINISTRATIVE DIRECTOR)
(248) 859-3900
Entity
Organization

Contact information

Practice address
2717 N GRANDVIEW BLVD STE 102, WAUKESHA, WI 53188-1672
(262) 513-0700
(262) 513-0707
Mailing address
39465 W 14 MILE RD, NOVI, MI 48377-1600
(248) 859-3900

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
2084P0800X
Psychiatry Physician
Primary
363A00000X
Physician Assistant
363LA2200X
Adult Health Nurse Practitioner

Other

Enumeration date
02/21/2018
Last updated
10/03/2024
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