| Northwest Journey - Northern Lights | |
|
69 N 28th St E Superior WI 54880-6525 | |
| (715) 718-2777 | |
| (715) 394-2869 |
| Full Name | Northwest Journey - Northern Lights |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 69 N 28th St E, Superior, Wisconsin |
| Authorized Official Name and Position | Jackie Maurer (OFFICE SUPERVISOR) |
| Authorized Official Contact | 7153497069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Journey - Northern Lights Po Box 309 Siren WI 54872-0309 Ph: (715) 349-7069 | Northwest Journey - Northern Lights 69 N 28th St E Superior WI 54880-6525 Ph: (715) 718-2777 |
| NPI Number | 1790143667 |
|---|---|
| Provider Enumeration Date | 02/05/2016 |
| Last Update Date | 03/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790143667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (Wisconsin) | Primary |
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