Provider Demographics
NPI:1740373463
Name:INSTITUTE FOR MENTAL HEALTH SC
Entity type:Organization
Organization Name:INSTITUTE FOR MENTAL HEALTH SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-821-6060
Mailing Address - Street 1:9401 W BELOIT RD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53227-4357
Mailing Address - Country:US
Mailing Address - Phone:414-321-4908
Mailing Address - Fax:414-321-4914
Practice Address - Street 1:9401 W BELOIT RD
Practice Address - Street 2:SUITE 315
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-4357
Practice Address - Country:US
Practice Address - Phone:414-321-4908
Practice Address - Fax:414-321-4914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty