| Delta Center Llc | |
|
196 E Third Street Fond Du Lac WI 54935 | |
| (920) 921-3343 | |
| (920) 921-0989 |
| Full Name | Delta Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 196 E Third Street, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Aimee Meyer (CO OWNER/CO DIRECTOR) |
| Authorized Official Contact | 9209213343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Center Llc 196 E Third Street Fond Du Lac WI 54935 Ph: (920) 921-3343 | Delta Center Llc 196 E Third Street Fond Du Lac WI 54935 Ph: (920) 921-3343 |
| NPI Number | 1669521233 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 12/26/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669521233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1274 (Wisconsin) | Primary |
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