Provider Demographics
NPI:1316908908
Name:MJCARE, INC.
Entity type:Organization
Organization Name:MJCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEISSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-329-2429
Mailing Address - Street 1:2725 S MOORLAND RD STE 301
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-3720
Mailing Address - Country:US
Mailing Address - Phone:414-329-2500
Mailing Address - Fax:414-329-2501
Practice Address - Street 1:2330 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4455
Practice Address - Country:US
Practice Address - Phone:414-220-4610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41808300Medicaid
WI41807900Medicaid
WI41808300Medicaid
VA496664Medicare Oscar/Certification
WI526531Medicare PIN