| Northwest Journey - Wisconsin Rapids Day Treatm | |
|
110 24th St S Wisconsin Rapids WI 54494-1906 | |
| (715) 424-5040 | |
| (715) 424-5720 |
| Full Name | Northwest Journey - Wisconsin Rapids Day Treatm |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 110 24th St S, Wisconsin Rapids, Wisconsin |
| Authorized Official Name and Position | Nick Kalambokidis (CFO) |
| Authorized Official Contact | 17153274402 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Journey - Wisconsin Rapids Day Treatm 110 24th St S Wisconsin Rapids WI 54494-1906 Ph: (715) 424-5040 | Northwest Journey - Wisconsin Rapids Day Treatm 110 24th St S Wisconsin Rapids WI 54494-1906 Ph: (715) 424-5040 |
| NPI Number | 1669599288 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 09/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669599288 | NPI | - | NPPES |
| 85575 | Other | MN | PREFERRED ONE |
| 43006100 | Medicaid | WI | |
| 42626 | Other | MN | HEALTH PARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 2291 (Wisconsin) | Primary |
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