NPI 1740403146
Waukesha County
Practice location
- Address
- 514 Riverview Ave, Waukesha, WI 53188-3632
- Phone
- (262) 548-7399
- Fax
- (262) 970-6696
- Mailing address
- 514 Riverview Ave, Waukesha, WI 53188-3631
Authorised official
- Name
- David M Derosier
- Title
- Credentialing Specialist
- Phone
- (262) 896-8431
Registered specialties (5)
Case Management Agency
Primary
Public Health or Welfare Agency
Community/Behavioral Health Agency
Mental Health Clinic/Center (Including Community Mental Health Center)
Psychiatric Hospital Unit
Registry record
- NPI
- 1740403146
- Entity type
- Organization
- NPI issued
- 11 Apr 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.