| Lss Janesville Clinic | |
|
612 N Randall Ave Suite A Janesville WI 53545-1958 | |
| (608) 752-7660 | |
| Not Available |
| Full Name | Lss Janesville Clinic |
|---|---|
| Speciality | Counselor |
| Location | 612 N Randall Ave, Janesville, Wisconsin |
| Authorized Official Name and Position | Joseph Arzbecker (COO) |
| Authorized Official Contact | 4143046900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lss Janesville Clinic 1904 Winnebago St Fl 2 Madison WI 53704-5315 Ph: (608) 234-2074 | Lss Janesville Clinic 612 N Randall Ave Suite A Janesville WI 53545-1958 Ph: (608) 752-7660 |
| NPI Number | 1386719177 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 12/04/2019 |
| Medicare PECOS PAC ID | 2668383084 |
|---|---|
| Medicare Enrollment ID | O20040204000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386719177 | NPI | - | NPPES |
| 1194954941 | Medicaid | WI |
| Provider Name | Sam P Romano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255348314 PECOS PAC ID: 0648214130 Enrollment ID: I20050615000659 |
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