| Penfield Children's Center, Inc. | |
|
833 N 26th St Milwaukee WI 53233-1507 | |
| (414) 344-7676 | |
| (414) 344-7739 |
| Full Name | Penfield Children's Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 833 N 26th St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Polina Makievsky (PRESIDENT & CEO) |
| Authorized Official Contact | 4143456300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Penfield Children's Center, Inc. 833 N 26th St Milwaukee WI 53233-1507 Ph: (414) 344-7676 | Penfield Children's Center, Inc. 833 N 26th St Milwaukee WI 53233-1507 Ph: (414) 344-7676 |
| NPI Number | 1275692410 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 04/24/2025 |
| Certification Date | 04/24/2025 |
| Medicare PECOS PAC ID | 4981056785 |
|---|---|
| Medicare Enrollment ID | O20240117002679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275692410 | NPI | - | NPPES |
| 41808500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (Wisconsin) | Primary |
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