| Ironwood Mental Health Llc | |
|
403 N Grand Ave # 101 Waukesha WI 53186-4984 | |
| (262) 300-4948 | |
| Not Available |
| Full Name | Ironwood Mental Health Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 403 N Grand Ave # 101, Waukesha, Wisconsin |
| Authorized Official Name and Position | Regina Van Gorden (OWNER) |
| Authorized Official Contact | 2623004948 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ironwood Mental Health Llc 403 N Grand Ave # 101 Waukesha WI 53186-4984 Ph: () - | Ironwood Mental Health Llc 403 N Grand Ave # 101 Waukesha WI 53186-4984 Ph: (262) 300-4948 |
| NPI Number | 1508640814 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 03/07/2024 |
| Certification Date | 03/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508640814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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