Provider Demographics
NPI:1386847291
Name:PSYCARE-MILWAUKEE LLC
Entity Type:Organization
Organization Name:PSYCARE-MILWAUKEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:414-271-3322
Mailing Address - Street 1:633 W WISCONSIN AVE STE 1810
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53203-1908
Mailing Address - Country:US
Mailing Address - Phone:414-271-3322
Mailing Address - Fax:414-271-2335
Practice Address - Street 1:633 W WISCONSIN AVE STE 1810
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53203-1908
Practice Address - Country:US
Practice Address - Phone:414-271-3322
Practice Address - Fax:414-271-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1445251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health