Provider Demographics
NPI:1538458898
Name:MIDWEST CLINICAL ASSOCIATES
Entity Type:Organization
Organization Name:MIDWEST CLINICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLSCHWANG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-202-1474
Mailing Address - Street 1:N77W16380 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-7408
Mailing Address - Country:US
Mailing Address - Phone:414-202-1474
Mailing Address - Fax:262-293-3048
Practice Address - Street 1:N77W16380 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-7408
Practice Address - Country:US
Practice Address - Phone:414-202-1474
Practice Address - Fax:262-293-3048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health