Andromeda Wellness Center Inc | |
582 Fargo Trl Middleton WI 53562-5667 | |
(608) 216-4374 | |
(608) 716-3148 |
Full Name | Andromeda Wellness Center Inc |
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Speciality | Social Worker |
Location | 582 Fargo Trl, Middleton, Wisconsin |
Authorized Official Name and Position | Nura Misty Budzinski (OWNER) |
Authorized Official Contact | 6082164374 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Andromeda Wellness Center Inc 6907 University Ave Ste 304 Middleton WI 53562-2767 Ph: (608) 216-4374 | Andromeda Wellness Center Inc 582 Fargo Trl Middleton WI 53562-5667 Ph: (608) 216-4374 |
NPI Number | 1144894494 |
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Provider Enumeration Date | 05/19/2021 |
Last Update Date | 05/19/2021 |
Certification Date | 04/27/2021 |
Medicare PECOS PAC ID | 7618375692 |
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Medicare Enrollment ID | O20211005002156 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144894494 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Misty Budzinski |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1851865018 PECOS PAC ID: 9537573738 Enrollment ID: I20210129001457 |
Provider Name | Lacey Kimpel |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1285010009 PECOS PAC ID: 5092105676 Enrollment ID: I20211214002853 |
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