| Moonlit Path Behavioral Health | |
|
13500 Watertown Plank Rd Ste 102 Elm Grove WI 53122-2222 | |
| (414) 867-4318 | |
| (414) 404-3623 |
| Full Name | Moonlit Path Behavioral Health |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 13500 Watertown Plank Rd Ste 102, Elm Grove, Wisconsin |
| Authorized Official Name and Position | Rebecca Sobanski (OWNER) |
| Authorized Official Contact | 4145871397 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moonlit Path Behavioral Health 2250 E Morgan Ave Milwaukee WI 53207-3753 Ph: (414) 587-1397 | Moonlit Path Behavioral Health 13500 Watertown Plank Rd Ste 102 Elm Grove WI 53122-2222 Ph: (414) 867-4318 |
| NPI Number | 1124622709 |
|---|---|
| Provider Enumeration Date | 11/24/2020 |
| Last Update Date | 01/03/2022 |
| Certification Date | 01/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124622709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Prisma Wellness, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13500 Watertown Plank Rd Ste 102, Elm Grove, WI 53122 Phone: 206-785-1015 Fax: 206-785-1023 | |
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American Behavioral Clinics Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15285 Watertown Plank Rd, Elm Grove, WI 53122 Phone: 262-797-2818 Fax: 262-797-2814 | |
Jir Psychiatry Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13500 Watertown Plank Rd, #102, Elm Grove, WI 53122 Phone: 262-794-3076 Fax: 949-655-2632 | |
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