| Glen Haven Counseling Clinic | |
|
6270 N Port Washington Rd Suite 201 Glendale WI 53217-4311 | |
| (414) 962-2284 | |
| Not Available |
| Full Name | Glen Haven Counseling Clinic |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6270 N Port Washington Rd, Glendale, Wisconsin |
| Authorized Official Name and Position | Jerrold Bernard Rousseau (OWNER) |
| Authorized Official Contact | 4149622284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glen Haven Counseling Clinic 6270 N Port Washington Rd Suite 201 Glendale WI 53217-4311 Ph: (414) 962-2284 | Glen Haven Counseling Clinic 6270 N Port Washington Rd Suite 201 Glendale WI 53217-4311 Ph: (414) 962-2284 |
| NPI Number | 1285844480 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285844480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1384 (Wisconsin) | Primary |
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