| Crisis Intervention | |
|
121 W Main St Port Washington WI 53074 | |
| (262) 284-8200 | |
| (262) 284-8104 |
| Full Name | Crisis Intervention |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 121 W Main St, Port Washington, Wisconsin |
| Authorized Official Name and Position | Anne Conners (FISCAL MANAGER) |
| Authorized Official Contact | 2622848200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crisis Intervention 121 W Main St Port Washington WI 53074-1813 Ph: (262) 284-8200 | Crisis Intervention 121 W Main St Port Washington WI 53074 Ph: (262) 284-8200 |
| NPI Number | 1518115112 |
|---|---|
| Provider Enumeration Date | 09/08/2008 |
| Last Update Date | 09/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518115112 | NPI | - | NPPES |
| 32979300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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