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Contact Information

BROOKDALE CLINIC
20700 WATERTOWN RD
STE 206
WAUKESHA, WI53186
 Phone: 262-513-0700
 Fax: 262-513-0707
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BROOKDALE CLINIC

NPI # 1568535474
LBN Legal business name BROOKDALE CLINIC
Authorized official ILANA HADAR - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/16/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
WI License # 904 057
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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