| Reconnections | |
|
921 W Glendale Ave Glendale WI 53209-6513 | |
| (414) 221-9293 | |
| (414) 221-9532 |
| Full Name | Reconnections |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 921 W Glendale Ave, Glendale, Wisconsin |
| Authorized Official Name and Position | B. Hal Dessel (OWNER, CLINIC DIRECTOR) |
| Authorized Official Contact | 4142219293 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reconnections 921 W Glendale Ave Glendale WI 53209-6513 Ph: (414) 221-9293 | Reconnections 921 W Glendale Ave Glendale WI 53209-6513 Ph: (414) 221-9293 |
| NPI Number | 1386784742 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386784742 | NPI | - | NPPES |
| 42211500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1775 (Wisconsin) | Primary |
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