Organization
ACACIA MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JOY STALLMAN (REGISTERED NURSE)
(414) 737-0280
Entity
Organization
Contact information
Practice address
6040 W LISBON AVE, MILWAUKEE, WI 53210-2116
(414) 871-9111
Mailing address
6040 W LISBON AVE, MILWAUKEE, WI 53210-2116
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
168390-030
WI
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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