| Lutheran Social Services Of Upper Michigan | |
|
131 S,. Main Street Fond Du Lac WI 54935 | |
| (920) 730-1349 | |
| (920) 724-2824 |
| Full Name | Lutheran Social Services Of Upper Michigan |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 131 S,. Main Street, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Vicky Ann Thull (SUBSTANCE ABUSE COUNSELOR-I T) |
| Authorized Official Contact | 9209245222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Social Services Of Upper Michigan 3003 B N. Richmond Street Appleton WI 54911-1148 Ph: (920) 730-1349 | Lutheran Social Services Of Upper Michigan 131 S,. Main Street Fond Du Lac WI 54935 Ph: (920) 730-1349 |
| NPI Number | 1558695304 |
|---|---|
| Provider Enumeration Date | 09/28/2009 |
| Last Update Date | 09/28/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558695304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 15448-130 (Wisconsin) | Primary |
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