| Tellurian, Inc. | |
|
414 Broadway St Suite 101 Baraboo WI 53913-2488 | |
| (608) 402-4312 | |
| (608) 355-0459 |
| Full Name | Tellurian, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 414 Broadway St, Baraboo, Wisconsin |
| Authorized Official Name and Position | Kevin Florek (CEO) |
| Authorized Official Contact | 6086632120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tellurian, Inc. 414 Broadway St Suite 101 Baraboo WI 53913-2488 Ph: (608) 402-4312 | Tellurian, Inc. 414 Broadway St Suite 101 Baraboo WI 53913-2488 Ph: (608) 402-4312 |
| NPI Number | 1104279330 |
|---|---|
| Provider Enumeration Date | 07/22/2016 |
| Last Update Date | 07/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104279330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3127 (Wisconsin) | Primary |
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