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411 N Bridge St Chippewa Falls WI 54729-2504 | |
| (833) 420-1103 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 411 N Bridge St, Chippewa Falls, Wisconsin |
| Authorized Official Name and Position | Tara Treglowne (COO) |
| Authorized Official Contact | 4142462300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6737 W Washington St Ste 2275 West Allis WI 53214-5666 Ph: (414) 246-2300 | 411 N Bridge St Chippewa Falls WI 54729-2504 Ph: (833) 420-1103 |
| NPI Number | 1386969723 |
|---|---|
| Provider Enumeration Date | 03/29/2010 |
| Last Update Date | 01/06/2025 |
| Certification Date | 01/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386969723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 13165 (Wisconsin) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 2872 (Wisconsin) | Primary |
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