Provider Demographics
NPI:1740355452
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:<UNAVAIL>
Other - Org Type:
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:414-246-2326
Mailing Address - Street 1:6737 W WASHINGTON ST STE 2275
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-5666
Mailing Address - Country:US
Mailing Address - Phone:414-246-2300
Mailing Address - Fax:
Practice Address - Street 1:3136 CRAIG RD
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6109
Practice Address - Country:US
Practice Address - Phone:715-385-9110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN SOCIAL SERVICES OF WI AND UPPER MI, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-21
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI=========OtherTIN