| Matt Talbot Recovery Services, Inc | |
|
611 N Grand Ave Waukesha WI 53186-4918 | |
| (414) 939-7145 | |
| (414) 321-5935 |
| Full Name | Matt Talbot Recovery Services, Inc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 611 N Grand Ave, Waukesha, Wisconsin |
| Authorized Official Name and Position | Karl Rajani (CEO) |
| Authorized Official Contact | 4143016381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matt Talbot Recovery Services, Inc 2819 W Highland Blvd Milwaukee WI 53208-3217 Ph: (414) 939-7145 | Matt Talbot Recovery Services, Inc 611 N Grand Ave Waukesha WI 53186-4918 Ph: (414) 939-7145 |
| NPI Number | 1659960102 |
|---|---|
| Provider Enumeration Date | 01/11/2021 |
| Last Update Date | 01/11/2021 |
| Certification Date | 01/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659960102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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