| Resonating Change Llc | |
|
613 Jefferson St Lake Mills WI 53551-1736 | |
| (920) 988-3372 | |
| (888) 972-4891 |
| Full Name | Resonating Change Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 613 Jefferson St, Lake Mills, Wisconsin |
| Authorized Official Name and Position | Venessa Farn (OWNER) |
| Authorized Official Contact | 3062404570 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Resonating Change Llc Po Box 335 Lake Mills WI 53551-0335 Ph: (306) 240-4570 | Resonating Change Llc 613 Jefferson St Lake Mills WI 53551-1736 Ph: (920) 988-3372 |
| NPI Number | 1477980969 |
|---|---|
| Provider Enumeration Date | 09/30/2013 |
| Last Update Date | 06/10/2021 |
| Certification Date | 06/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477980969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 4567-125 (Wisconsin) | Primary |
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