Innerchange, Inc. | |
1401 Main St Onalaska WI 54650-2858 | |
(608) 783-2186 | |
(608) 781-3405 |
Full Name | Innerchange, Inc. |
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Speciality | Counselor - Mental Health |
Location | 1401 Main St, Onalaska, Wisconsin |
Authorized Official Name and Position | Thomas B Roberts (PRESIDENT) |
Authorized Official Contact | 6087832186 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Innerchange, Inc. 1401 Main St Onalaska WI 54650-2858 Ph: (608) 783-2186 | Innerchange, Inc. 1401 Main St Onalaska WI 54650-2858 Ph: (608) 783-2186 |
NPI Number | 1770634370 |
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Provider Enumeration Date | 01/12/2007 |
Last Update Date | 03/05/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770634370 | NPI | - | NPPES |
42165700 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 1435 (Wisconsin) | Primary |
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