Organization Active NPI

St. Charles Youth & Family Services

  • Mental Illness Community Based Residential Treatment Facility
  • Wauwatosa, WI
National Provider Identifier
1669648960
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
1005239 Issued in WI
Legal business name
ST. CHARLES YOUTH & FAMILY SERVICES
Practice address
9501 W Watertown Plank Rd
Wauwatosa, WI 53226-3552
Phone
(414) 476-3710
Fax
(414) 778-5985
NPI assigned
May 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Authorized official

Name
Ms. Catherine Connolly
Title
President
Phone
(414) 476-3710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 1005239 WI Primary

Addresses

Primary practice location

9501 W Watertown Plank Rd
Wauwatosa, WI 53226-3552

Mailing address

151 S 84TH St
Milwaukee, WI 53214-1456
Phone (414) 476-3710

Other identifiers 1

IdentifierTypeStateIssuer
43018000MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
St Charles Youth Family Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

151 S 84th St
Milwaukee, WI 53214
Phone (414) 257-4300

9501 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 257-3141

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1669648960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 S 84TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532141456",
            "telephone_number": "414-476-3710",
            "fax_number": "414-778-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 W WATERTOWN PLANK RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263552",
            "telephone_number": "414-476-3710",
            "fax_number": "414-778-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CHARLES YOUTH & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-476-3710",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "WI",
            "license": "1005239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43018000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.