| Shanti Community Services, Llc | |
|
405 E Forest St Oconomowoc WI 53066-3707 | |
| (262) 955-1079 | |
| (262) 205-7089 |
| Full Name | Shanti Community Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 405 E Forest St, Oconomowoc, Wisconsin |
| Authorized Official Name and Position | Sharon Louise Kleppe (OWNER) |
| Authorized Official Contact | 2622122764 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shanti Community Services, Llc 405 E Forest St Oconomowoc WI 53066-3707 Ph: (262) 955-1079 | Shanti Community Services, Llc 405 E Forest St Oconomowoc WI 53066-3707 Ph: (262) 955-1079 |
| NPI Number | 1508565342 |
|---|---|
| Provider Enumeration Date | 03/01/2023 |
| Last Update Date | 03/01/2023 |
| Certification Date | 03/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508565342 | NPI | - | NPPES |
| 100180598 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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