| Tellurian | |
|
1720 Jackson St La Crosse WI 54601-6679 | |
| (608) 222-7311 | |
| Not Available |
| Full Name | Tellurian |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 1720 Jackson St, La Crosse, Wisconsin |
| Authorized Official Name and Position | Erica Mueller (QUALITY ASSURANCE MANAGER) |
| Authorized Official Contact | 6082048547 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tellurian 5900 Monona Dr Ste 300 Monona WI 53716-3561 Ph: (608) 204-8547 | Tellurian 1720 Jackson St La Crosse WI 54601-6679 Ph: (608) 222-7311 |
| NPI Number | 1881459824 |
|---|---|
| Provider Enumeration Date | 02/19/2024 |
| Last Update Date | 02/20/2024 |
| Certification Date | 02/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881459824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Primary |
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