Provider Demographics
NPI:1417130071
Name:MIDWEST COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:MIDWEST COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:NOWAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, ACSW
Authorized Official - Phone:414-327-4255
Mailing Address - Street 1:9401 W BELOIT RD
Mailing Address - Street 2:414
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53227-4357
Mailing Address - Country:US
Mailing Address - Phone:414-327-4255
Mailing Address - Fax:414-327-4655
Practice Address - Street 1:9401 W BELOIT RD
Practice Address - Street 2:414
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-4357
Practice Address - Country:US
Practice Address - Phone:414-327-4255
Practice Address - Fax:414-327-4655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management