institution
Lakeshores Outpatient Clinic
Mental Health Clinic/Center (Including Community Mental Health Center) in Kenosha, Wisconsin
NPI 1629111943

Lakeshores Outpatient Clinic is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Kenosha, WI and is specialized in Mental Health (Including Community Mental Health Center). Lakeshores Outpatient Clinic practices in Kenosha, WI. The NPI Number for Lakeshores Outpatient Clinic is 1629111943 and holds a License No. 2605 (Wisconsin).

The current practice location address for Lakeshores Outpatient Clinic is 3917 47Th Ave, Kenosha, WI and can be reached out via phone at 262-656-9975 and via fax at 262-656-9974.

Location: 3917 47Th Ave, Kenosha, WI, 53144-1956
institution
Provider Profile Details
NPI Number
1629111943
Provider Name
Lakeshores Outpatient Clinic
Credential
Provider Entity Type
Organization
Address
3917 47Th Ave, Kenosha, WI, 53144-1956
Phone Number
262-656-9975
Fax Number
262-656-9974
Provider Enumeration Date
02/15/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
42242400 05 WI
institution
Provider Business Practice Location Address Details
Address
3917 47Th Ave
City
State
Zip
53144-1956
Phone Number
262-656-9975
Fax Number
262-656-9974
person
Provider Business Mailing Address Details
Address
3917 47Th Ave
City
State
Zip
53144-1956
Phone Number
262-656-9975
Fax Number
262-656-9974
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
2605 (Wisconsin)
Definition
Definition to come...
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