Provider Demographics
NPI:1093008575
Name:FOREST VIEW HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:FOREST VIEW HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KANE
Authorized Official - Suffix:III
Authorized Official - Credentials:MED, LCSW, LPC
Authorized Official - Phone:414-529-9044
Mailing Address - Street 1:11035 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-2541
Mailing Address - Country:US
Mailing Address - Phone:414-529-9044
Mailing Address - Fax:414-529-9055
Practice Address - Street 1:11035 W FOREST HOME AVE
Practice Address - Street 2:
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-2541
Practice Address - Country:US
Practice Address - Phone:414-529-9044
Practice Address - Fax:414-529-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No132700000XDietary & Nutritional Service ProvidersDietary ManagerGroup - Multi-Specialty