NPIMap

Organization Active NPI

Matt Talbot Recovery Services, Inc

  • Substance Abuse Rehabilitation Facility
  • Waukesha, WI
National Provider Identifier
1659960102
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MATT TALBOT RECOVERY SERVICES, INC
Practice address
611 N Grand Ave
Waukesha, WI 53186-4918
Phone
(414) 939-7145
Fax
(414) 321-5935
NPI assigned
Jan 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Authorized official

Name
Karl Rajani
Title
Ceo
Phone
(414) 301-6381

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

611 N Grand Ave
Waukesha, WI 53186-4918

Mailing address

2819 W Highland Blvd
Milwaukee, WI 53208-3217
Phone (414) 939-7145

Other names 1

  • Samson House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Matt Talbot Recovery Services Inc6 organizations share this tax ID, including this one

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": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1659960102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 W HIGHLAND BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532083217",
            "telephone_number": "414-939-7145",
            "fax_number": "414-321-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N GRAND AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864918",
            "telephone_number": "414-939-7145",
            "fax_number": "414-321-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATT TALBOT RECOVERY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "RAJANI",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-301-6381"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samson House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.