| Lakeside Neurocare Limited | |
|
191 Memorial Dr Berlin WI 54923-1241 | |
| (920) 223-5580 | |
| (920) 223-5592 |
| Full Name | Lakeside Neurocare Limited |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 191 Memorial Dr, Berlin, Wisconsin |
| Authorized Official Name and Position | Susan M Golden (BUSINESS MANAGER) |
| Authorized Official Contact | 9202235582 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Neurocare Limited 2700 W 9th Ave Ste 225 Oshkosh WI 54904-7865 Ph: (920) 223-5580 | Lakeside Neurocare Limited 191 Memorial Dr Berlin WI 54923-1241 Ph: (920) 223-5580 |
| NPI Number | 1932391968 |
|---|---|
| Provider Enumeration Date | 08/14/2007 |
| Last Update Date | 04/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932391968 | NPI | - | NPPES |
| 32820600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Wisconsin) | Primary |
Jason L. Fairweather Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 553 Broadway, Berlin, WI 54923 Phone: 920-204-6590 | |
N/a Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 141 W Huron St, Berlin, WI 54923 Phone: 920-290-0107 |