| Changequest, Llc | |
|
11345 N Port Washington Rd Suite 202 Mequon WI 53092 | |
| (262) 261-4698 | |
| Not Available |
| Full Name | Changequest, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 11345 N Port Washington Rd, Mequon, Wisconsin |
| Authorized Official Name and Position | Anne M Fors Spahr (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2622614698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changequest, Llc 11345 N Port Washington Rd Suite 202 Mequon WI 53092 Ph: (262) 261-4698 | Changequest, Llc 11345 N Port Washington Rd Suite 202 Mequon WI 53092 Ph: (262) 261-4698 |
| NPI Number | 1457185852 |
|---|---|
| Provider Enumeration Date | 08/28/2024 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457185852 | NPI | - | NPPES |
| 1083737068 | Other | WI | SELF |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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