NPI 1407988892
Waukesha County
Practice location
- Address
- 1501 Airport Rd, Waukesha, WI 53188-3632
- Phone
- (262) 548-7950
- Fax
- (262) 896-8046
- Mailing address
- 514 Riverview Ave Attn: Fiscal Department, Waukesha, WI 53188-3632
Authorised official
- Name
- David M Derosier
- Title
- Credentialing Specialist
- Phone
- (262) 548-8431
Registered specialties
Psychiatric Hospital
Primary
Registry record
- NPI
- 1407988892
- Entity type
- Organization
- NPI issued
- 12 Mar 2007
- Record last updated
- 10 Nov 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.