| Thundermist, Inc. | |
|
2108a Silvernail Rd Suite 116 Pewaukee WI 53072-5526 | |
| (888) 468-9981 | |
| Not Available |
| Full Name | Thundermist, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 2108a Silvernail Rd, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Sean B Jones (CEO/PRESIDENT) |
| Authorized Official Contact | 8888984591 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thundermist, Inc. 2108a Silvernail Rd Suite 116 Pewaukee WI 53072-5526 Ph: (888) 468-9981 | Thundermist, Inc. 2108a Silvernail Rd Suite 116 Pewaukee WI 53072-5526 Ph: (888) 468-9981 |
| NPI Number | 1003179953 |
|---|---|
| Provider Enumeration Date | 06/15/2012 |
| Last Update Date | 06/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003179953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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