Provider Demographics
NPI:1376563593
Name:LUTHERAN SOCIAL SERVICES OF WISCONSIN AND UPPER MICHIGAN, INC
Entity Type:Organization
Organization Name:LUTHERAN SOCIAL SERVICES OF WISCONSIN AND UPPER MICHIGAN, INC
Other - Org Name:LSS BIRTH TO THREE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARZBECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-246-2300
Mailing Address - Street 1:PO BOX 1462
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53187-1462
Mailing Address - Country:US
Mailing Address - Phone:262-443-3163
Mailing Address - Fax:
Practice Address - Street 1:6737 W WASHINGTON ST STE 2275
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-5666
Practice Address - Country:US
Practice Address - Phone:262-443-3163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41203900Medicaid