NPIMap

Organization Active NPI

Life Changing Ministries Substance Abuse Services

  • Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1679981328
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES
Practice address
1134 W North Ave 2ND Floor
Milwaukee, WI 53205
Phone
(414) 269-9660
Fax
(414) 755-0698
NPI assigned
Jul 25, 2014
Organization subpart
Yes
Parent organization
LIFE CHANGING MINISTRIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Karina Chelsky
Title
Practice Manager
Phone
(414) 467-8884

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Abuse Rehabilitation Facility 324500000X 3045 WI

Addresses

Primary practice location

1134 W North Ave 2ND Floor
Milwaukee, WI 53205

Mailing address

1134 W North Ave 2ND Floor
Milwaukee, WI 53205-1333
Phone (414) 269-9660

Other identifiers 3

IdentifierTypeStateIssuer
52D2142323OtherWIFDA CLIA
100041767MedicaidWI
100043806MedicaidWI

National Provider Directory

National Provider Directory
Part of
Life Changing Ministries Substance Abuse Services

Locations

1134 W North Ave
Fl 2
Milwaukee, WI 53205
Phone (414) 269-9660

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1679981328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 W NORTH AVE 2ND FLOOR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051333",
            "telephone_number": "414-269-9660",
            "fax_number": "414-755-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 W NORTH AVE 2ND FLOOR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53205",
            "telephone_number": "414-269-9660",
            "fax_number": "414-755-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGING MINISTRIES SUBSTANCE ABUSE SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFE CHANGING MINISTRIES",
        "enumeration_date": "2014-07-25",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "CHELSKY",
        "authorized_official_first_name": "KARINA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "414-467-8884"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "WI",
            "license": "3045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FDA CLIA",
            "identifier": "52D2142323",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100041767",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100043806",
            "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 Jun 16, 2018; 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.