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1823 E Geneva St Ste 1807a Delavan WI 53115-2039 | |
(615) 861-6000 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Methadone |
Location | 1823 E Geneva St Ste 1807a, Delavan, Wisconsin |
Authorized Official Name and Position | Brian Phillip Farley (VP & SECRETARY) |
Authorized Official Contact | 1567169335 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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6183 Paseo Del Norte Ste 200 Carlsbad CA 92011-1151 Ph: (615) 861-6000 | 1823 E Geneva St Ste 1807a Delavan WI 53115-2039 Ph: (615) 861-6000 |
NPI Number | 1306606694 |
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Provider Enumeration Date | 03/21/2024 |
Last Update Date | 03/28/2024 |
Certification Date | 03/28/2024 |
Identifier | Type | State | Issuer |
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1306606694 | NPI | - | NPPES |