| Coulee Council On Addictions | |
|
921 West Ave S La Crosse WI 54601-4745 | |
| (608) 784-4177 | |
| (608) 784-6302 |
| Full Name | Coulee Council On Addictions |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 921 West Ave S, La Crosse, Wisconsin |
| Authorized Official Name and Position | Patricia Ruda (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6087844177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coulee Council On Addictions 921 West Ave S La Crosse WI 54601-4745 Ph: (608) 784-4177 | Coulee Council On Addictions 921 West Ave S La Crosse WI 54601-4745 Ph: (608) 784-4177 |
| NPI Number | 1306123070 |
|---|---|
| Provider Enumeration Date | 11/09/2011 |
| Last Update Date | 11/09/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306123070 | NPI | - | NPPES |
| 42230400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1240 (Wisconsin) | Primary |
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