| Waushara County Crisis Intervention | |
|
230 W Park Street Wautoma WI 54982-9031 | |
| (920) 787-6550 | |
| (920) 787-0421 |
| Full Name | Waushara County Crisis Intervention |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 230 W Park Street, Wautoma, Wisconsin |
| Authorized Official Name and Position | Victoria L Ida (ACCOUNT CLERK) |
| Authorized Official Contact | 9207876618 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waushara County Crisis Intervention Po Box 1230 Wautoma WI 54982-1230 Ph: (920) 787-6600 | Waushara County Crisis Intervention 230 W Park Street Wautoma WI 54982-9031 Ph: (920) 787-6550 |
| NPI Number | 1598938557 |
|---|---|
| Provider Enumeration Date | 04/10/2008 |
| Last Update Date | 12/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598938557 | NPI | - | NPPES |
| 32976970 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1980 (Wisconsin) | Primary |
Waushara County Crisis Intervention Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 380 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421 | |
Waushara County Clinical Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 Park St, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421 | |
Waushara County Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 380 S Townline Rd, Wautoma, WI 54982 Phone: 207-876-5509 |