Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CLEANSLATE MEDICAL GROUP OF WISCONSIN, SC
Active OrganizationCLEANSLATE MEDICAL GROUP OF WISCONSIN, SC is a Addiction Medicine (Internal Medicine) organization located in GLENDALE, Wisconsin. NPI 1518404854 is currently active in the NPPES registry. Verify at CMS.
Addiction Medicine (Internal Medicine) · GLENDALE, WI
Registration Details
- NPI Number
- 1518404854
- Provider Type
- Organization
- NPI Issued
- Jan 25, 2017 (9.5815578014405 yrs)
- Last Updated
- Dec 17, 2025
Practice Information
- Address
-
377 W RIVER WOODS PKWY STE 201GLENDALE, WI, 532121088Browse WI providers · Browse ZIP 53212
- Phone
- 4133236880
- Fax
- 8332797074
- Primary Specialty
-
Addiction Medicine (Internal Medicine)
207RA0401X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.