Organization
LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES
Active
Parent organization
LIFE CHANGING MINISTRIES
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFE CHANGING MINISTRIES
Authorized official
KARINA CHELSKY (PRACTICE MANAGER)
(414) 467-8884
Entity
Organization
Contact information
Practice address
1134 W NORTH AVE 2ND FLOOR, MILWAUKEE, WI 53205
(414) 269-9660
(414) 755-0698
Mailing address
1134 W NORTH AVE 2ND FLOOR, MILWAUKEE, WI 53205-1333
(414) 269-9660
(414) 755-0698
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
324500000X
Substance Abuse Rehabilitation Facility
3045
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100041767
—
WI
05
—
100043806
—
WI
01
—
52D2142323
FDA CLIA
WI
Enumeration date
07/25/2014
Last updated
06/16/2018
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