| James D Wiedenhoeft Partnership | |
|
N5367 Mayflower Rd Shiocton WI 54170-8934 | |
| (920) 986-3003 | |
| (920) 986-3004 |
| Full Name | James D Wiedenhoeft Partnership |
|---|---|
| Speciality | Community/behavioral Health |
| Location | N5367 Mayflower Rd, Shiocton, Wisconsin |
| Authorized Official Name and Position | Ann M Dake (CEO) |
| Authorized Official Contact | 9209863003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James D Wiedenhoeft Partnership N5367 Mayflower Rd Shiocton WI 54170-8934 Ph: (920) 986-3003 | James D Wiedenhoeft Partnership N5367 Mayflower Rd Shiocton WI 54170-8934 Ph: (920) 986-3003 |
| NPI Number | 1497921183 |
|---|---|
| Provider Enumeration Date | 05/02/2008 |
| Last Update Date | 02/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497921183 | NPI | - | NPPES |
| 42192600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1578 (Wisconsin) | Primary |
Chaps Academy, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: N5367 Mayflower Rd, Shiocton, WI 54170 Phone: 920-986-3003 Fax: 920-986-3004 | |
James D Wiedenhoeft Partnership Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: N5367 Mayflower Rd, Shiocton, WI 54170 Phone: 920-986-3003 Fax: 920-986-3004 |