NPIMap

Organization Active NPI

Easter Seals Southeast Wisconsin

  • Community/Behavioral Health Agency
  • Milwaukee, WI
National Provider Identifier
1396037511
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BCBA 103K00000X Issued in WI
Legal business name
EASTER SEALS SOUTHEAST WISCONSIN
Practice address
3090 N 53Rd St
Milwaukee, WI 53210-1617
Phone
(414) 449-4444
NPI assigned
May 5, 2011
Organization subpart
Yes
Parent organization
EASTER SEALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kimberly Jurowski, BCBA
Title
Behavior Analyst
Phone
(262) 581-5394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BCBA 103K00000X WI Primary

Addresses

Primary practice location

3090 N 53Rd St
Milwaukee, WI 53210-1617

Mailing address

3090 N 53Rd St
Milwaukee, WI 53210-1617
Phone (414) 449-4444

Other identifiers 1

IdentifierTypeStateIssuer
41209100MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals Southeast Wisconsin Inc6 organizations share this tax ID, including this one
Part of
Easter Seals Southeast Wisconsin Inc

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304553600000",
    "number": "1396037511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 N 53RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101617",
            "telephone_number": "414-449-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 N 53RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101617",
            "telephone_number": "414-449-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS SOUTHEAST WISCONSIN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTER SEALS",
        "enumeration_date": "2011-05-05",
        "last_updated": "2011-05-05",
        "status": "A",
        "authorized_official_last_name": "JUROWSKI",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "262-581-5394",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "BCBA 103K00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41209100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.