Organization
AURORA PSYCHIATRIC HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARA RICHARDSON (VP MANAGED HEALTH)
(704) 631-0450
Entity
Organization
Contact information
Practice address
1220 DEWEY AVE, WAUWATOSA, WI 53213
(414) 454-6600
Mailing address
1220 DEWEY AVE, WAUWATOSA, WI 53213
(414) 454-6600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
283Q00000X
Psychiatric Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42194900
—
WI
05
—
42195000
—
WI
05
—
42195200
—
WI
05
—
42195600
—
WI
05
—
42228600
—
WI
05
—
42228800
—
WI
05
—
42229800
—
WI
05
—
42229900
—
WI
05
—
42230600
—
WI
Enumeration date
04/19/2007
Last updated
02/24/2025
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