| Roots4change Coop | |
|
701 E Washington Ave Ste 102 Madison WI 53703-2958 | |
| (904) 385-8151 | |
| Not Available |
| Full Name | Roots4change Coop |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 701 E Washington Ave Ste 102, Madison, Wisconsin |
| Authorized Official Name and Position | Jennifer Valencia (PRESIDENT) |
| Authorized Official Contact | 7048845284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots4change Coop 701 E Washington Ave Ste 102 Madison WI 53703-2958 Ph: (904) 385-8151 | Roots4change Coop 701 E Washington Ave Ste 102 Madison WI 53703-2958 Ph: (904) 385-8151 |
| NPI Number | 1730915190 |
|---|---|
| Provider Enumeration Date | 09/11/2024 |
| Last Update Date | 09/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730915190 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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