| Refresh Midwest Operations, Sc | |
|
2501 Hanley Rd Ste 202 Hudson WI 54016-8705 | |
| (715) 381-1980 | |
| (715) 381-1906 |
| Full Name | Refresh Midwest Operations, Sc |
|---|---|
| Speciality | Psychologist |
| Location | 2501 Hanley Rd Ste 202, Hudson, Wisconsin |
| Authorized Official Name and Position | Audrey Nevins (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 7153811980 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Refresh Midwest Operations, Sc 2501 Hanley Rd Ste 202 Hudson WI 54016-8705 Ph: (715) 381-1980 | Refresh Midwest Operations, Sc 2501 Hanley Rd Ste 202 Hudson WI 54016-8705 Ph: (715) 381-1980 |
| NPI Number | 1932625357 |
|---|---|
| Provider Enumeration Date | 08/17/2017 |
| Last Update Date | 05/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932625357 | NPI | - | NPPES |
| 1669822763 | Medicaid | WI | |
| 171-004-3070 | Medicaid | WI | |
| 1053463976 | Medicaid | WI | |
| 1245667633 | Medicaid | WI | |
| 1336248137 | Medicaid | WI | |
| 1427000991 | Medicaid | WI | |
| 1649514803 | Medicaid | WI | |
| 1518208206 | Medicaid | WI | |
| 1689947384 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1436-057 (Wisconsin) | Primary |
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