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508 Campus St Suite 6 Milton WI 53563-1750 | |
| (608) 868-5122 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 508 Campus St, Milton, Wisconsin |
| Authorized Official Name and Position | Lois Ann Hadley (DIRECTOR) |
| Authorized Official Contact | 6088685122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
508 Campus St Suite 6 Milton WI 53563-1750 Ph: (608) 868-5122 | 508 Campus St Suite 6 Milton WI 53563-1750 Ph: (608) 868-5122 |
| NPI Number | 1154402501 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 02/20/2008 |
| Medicare PECOS PAC ID | 1254340318 |
|---|---|
| Medicare Enrollment ID | O20060418000441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154402501 | NPI | - | NPPES |
| 42208000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Wisconsin) | Primary |
| Provider Name | Lois A Hadley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134200579 PECOS PAC ID: 7315956471 Enrollment ID: I20100722001018 |