Professional Recovery Network

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1748 Issued in WI

Legal business name

PROFESSIONAL RECOVERY NETWORK

Practice address

2422 North Grandview Blvd
Waukesha, WI 53188

Phone

(262) 549-6600

Fax

(262) 549-6698

NPI assigned

May 17, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles John Engel, MDNPI 1649484205

Title

President

Phone

(262) 549-6600

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles J Engel, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Waukesha, WI
  • NPI 1649484205
  Authorized official Same address or phone
• Michael S Goldstone, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Waukesha, WI
  • NPI 1851505416
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811104995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 NORTH GRANDVIEW BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-549-6600",
            "fax_number": "262-549-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 NORTH GRANDVIEW BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-549-6600",
            "fax_number": "262-549-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL RECOVERY NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENGEL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-549-6600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "WI",
            "license": "1747",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "WI",
            "license": "1748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa K Printz, LPC
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• Substance Abuse Rehabilitation Facility in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Substance Abuse Rehabilitation Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.