| |
711 N Bridge St Room 122 Chippewa Falls WI 54729-1845 | |
(715) 726-7788 | |
(715) 726-4560 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 711 N Bridge St, Chippewa Falls, Wisconsin |
Authorized Official Name and Position | Larry Winter (DEPT OF HUMAN SERVICES DIRECTOR) |
Authorized Official Contact | 7157267788 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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711 N Bridge St Room 305 Chippewa Falls WI 54729-1845 Ph: (715) 726-7788 | 711 N Bridge St Room 122 Chippewa Falls WI 54729-1845 Ph: (715) 726-7788 |
NPI Number | 1427225101 |
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Provider Enumeration Date | 05/13/2008 |
Last Update Date | 07/18/2013 |
Identifier | Type | State | Issuer |
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1427225101 | NPI | - | NPPES |
32976500 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 1196 (Wisconsin) | Primary |
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