Provider Demographics
NPI:1457788242
Name:ALARUS HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ALARUS HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/SAC-IT
Authorized Official - Phone:262-707-4671
Mailing Address - Street 1:1971 WASHINGTON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-2102
Mailing Address - Country:US
Mailing Address - Phone:262-377-6276
Mailing Address - Fax:262-377-6289
Practice Address - Street 1:1971 WASHINGTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-2102
Practice Address - Country:US
Practice Address - Phone:262-377-6276
Practice Address - Fax:262-377-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4842-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1669701561Medicaid