| Wi Awaken Llc | |
|
157 S Pine St Burlington WI 53105-1911 | |
| (262) 342-5188 | |
| Not Available |
| Full Name | Wi Awaken Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 157 S Pine St, Burlington, Wisconsin |
| Authorized Official Name and Position | Stephanie Coates (THERAPIST) |
| Authorized Official Contact | 2623790942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wi Awaken Llc Po Box 189 Burlington WI 53105-0189 Ph: (262) 342-5188 | Wi Awaken Llc 157 S Pine St Burlington WI 53105-1911 Ph: (262) 342-5188 |
| NPI Number | 1073979530 |
|---|---|
| Provider Enumeration Date | 01/13/2016 |
| Last Update Date | 01/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073979530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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