| Coulee Youth Centers, Inc. | |
|
231 Copeland Ave La Crosse WI 54603-3086 | |
| (608) 782-7152 | |
| (608) 785-1241 |
| Full Name | Coulee Youth Centers, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 231 Copeland Ave, La Crosse, Wisconsin |
| Authorized Official Name and Position | Steven T. Eide (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6087827152 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coulee Youth Centers, Inc. 231 Copeland Ave P.o.box 1836 La Crosse WI 54603-3086 Ph: (608) 782-7152 | Coulee Youth Centers, Inc. 231 Copeland Ave La Crosse WI 54603-3086 Ph: (608) 782-7152 |
| NPI Number | 1821281577 |
|---|---|
| Provider Enumeration Date | 08/24/2007 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821281577 | NPI | - | NPPES |
| 42164300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1241 (Wisconsin) | Primary |
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