| Journey Of Grace | |
|
5497 W Waterford Ln Suite A Appleton WI 54913-8509 | |
| (920) 750-6120 | |
| (920) 750-6121 |
| Full Name | Journey Of Grace |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5497 W Waterford Ln, Appleton, Wisconsin |
| Authorized Official Name and Position | Deborah Ann Bongers (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 9207506120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Journey Of Grace 2636 W Sunnyview Cir Appleton WI 54914-1164 Ph: (920) 750-6120 | Journey Of Grace 5497 W Waterford Ln Suite A Appleton WI 54913-8509 Ph: (920) 750-6120 |
| NPI Number | 1619325164 |
|---|---|
| Provider Enumeration Date | 05/25/2016 |
| Last Update Date | 05/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619325164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5970-125 (Wisconsin) | Primary |
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