Organization
NORTH SHORE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER STROM LPC (DIRECTOR/MANAGER)
(262) 241-5955
Entity
Organization
Contact information
Practice address
1500 W MARKET ST STE 200, MEQUON, WI 53092-5083
(262) 241-5955
(262) 241-5926
Mailing address
1500 W MARKET ST STE 200, MEQUON, WI 53092-5083
(262) 241-5955
(262) 241-5926
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
05
—
42204700
—
WI
Enumeration date
11/13/2006
Last updated
11/15/2024
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