Organization
AURORA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAN NELSON (CFO)
(414) 299-1610
Entity
Organization
Contact information
Practice address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215
(877) 576-3544
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215
(877) 576-3544
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000073975
MEDICARE PIN
WI
05
—
32895600
—
WI
05
—
42250600
—
WI
Enumeration date
04/23/2007
Last updated
06/11/2018
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