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903 Mineral Point Ave Janesville WI 53548-2970 | |
| (608) 756-5555 | |
| (608) 756-0174 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 903 Mineral Point Ave, Janesville, Wisconsin |
| Authorized Official Name and Position | Shannon Dunphy-alexander (CFO AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6087573126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1000 Mineral Point Ave Janesville WI 53548 Ph: (608) 756-6000 | 903 Mineral Point Ave Janesville WI 53548-2970 Ph: (608) 756-5555 |
| NPI Number | 1669685129 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 12/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669685129 | NPI | - | NPPES |
| 42232800 | Medicaid | WI | |
| 42180300 | Medicaid | WI | |
| 42180221 | Medicaid | WI | |
| 42180321 | Medicaid | WI | |
| 43171321 | Medicaid | WI | |
| 42180200 | Medicaid | WI | |
| 43009200 | Medicaid | WI | |
| 11011426 | Medicaid | WI |
Liberty Star Medical Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1905 Center Ave, Suite 5, Janesville, WI 53546 Phone: 608-563-4213 Fax: 866-998-1030 | |
Quad/med, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1703 Plainfield Ave, Janesville, WI 53545 Phone: 414-566-4000 | |
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