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13111 Lax Chapel Rd Kiel WI 53042-3954 | |
| (920) 894-1374 | |
| (920) 894-1373 |
| Full Name | |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 13111 Lax Chapel Rd, Kiel, Wisconsin |
| Authorized Official Name and Position | Susan Beattie (OWNER / CEO) |
| Authorized Official Contact | 9202860189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 347 Kiel WI 53042-0347 Ph: (920) 894-1374 | 13111 Lax Chapel Rd Kiel WI 53042-3954 Ph: (920) 894-1374 |
| NPI Number | 1780081174 |
|---|---|
| Provider Enumeration Date | 12/01/2014 |
| Last Update Date | 09/28/2022 |
| Certification Date | 09/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780081174 | NPI | - | NPPES |
| 1265068415 | Medicaid | WI | |
| 1861022022 | Medicaid | WI | |
| 1053468207 | Medicaid | WI | |
| 1336105501 | Medicaid | WI | |
| 1780262840 | Medicaid | WI | |
| 1659907392 | Medicaid | WI |
Barbara K. Henry Lcsw, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 Fremont St, Kiel, WI 53042 Phone: 920-894-7900 Fax: 920-894-7900 |