Brotoloc South, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BROTOLOC SOUTH, INC.

Practice address

5812 W Burnham St
West Allis, WI 53219-1524

Phone

(414) 543-3200

Fax

(414) 543-3269

NPI assigned

Dec 10, 2009

Organization subpart

Yes

Parent organization

BROTOLOC SOUTH, INC.As reported in NPPES

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

Authorized official

Name

Doug E Sveda

Title

Director

Phone

(414) 543-3200

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Brotoloc South Inc3 organizations share this tax ID, including this one

Part of

Brotoloc South Inc

Other organizations with this tax ID 2

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

• Brotoloc South, Inc.

  • Non-emergency Medical Transport (VAN)
  • West Allis, WI
  • NPI 1437472966
  NPD tax ID
• Brotoloc South, Inc.

  • Non-emergency Medical Transport (VAN)
  • Whitewater, WI
  • NPI 1518009596
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Brotoloc South, Inc.

  • Non-emergency Medical Transport (VAN)
  • Whitewater, WI
  • NPI 1518009596
  NPPES parent name

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1982933503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5812 W BURNHAM ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532191524",
            "telephone_number": "414-543-3200",
            "fax_number": "414-543-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5812 W BURNHAM ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532191524",
            "telephone_number": "414-543-3200",
            "fax_number": "414-543-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROTOLOC SOUTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROTOLOC SOUTH, INC.",
        "enumeration_date": "2009-12-10",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "SVEDA",
        "authorized_official_first_name": "DOUG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "414-543-3200"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42207400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broadstep-Wisconsin, Inc.
• Emily Marie Bronikowski, PHARMD, MBA
• Brotoloc Outpatient Clinic
• Brotoloc Sesmv
• Brotoloc South, Inc.
• Eboney Brown, PHARMD
• Jessica Brown
• Julie Anne Brown, M.S./CCC-SLP
• Nathaniel Holmes Brown, LCSW
• Roxie Brown

• Mental Health Clinic/Center (Including Community Mental Health Center) in West Allis, WI
• Providers in West Allis, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.