| Willow Creek Ranch, Inc. | |
|
7404 Northwest Hwy # 83 Mukwonago WI 53149-8903 | |
| (414) 791-2509 | |
| Not Available |
| Full Name | Willow Creek Ranch, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 7404 Northwest Hwy # 83, Mukwonago, Wisconsin |
| Authorized Official Name and Position | Jennifer S. Pape (FOUNDER/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4147912509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Creek Ranch, Inc. 7404 Northwest Hwy # 83 Mukwonago WI 53149-8903 Ph: (414) 791-2509 | Willow Creek Ranch, Inc. 7404 Northwest Hwy # 83 Mukwonago WI 53149-8903 Ph: (414) 791-2509 |
| NPI Number | 1417334988 |
|---|---|
| Provider Enumeration Date | 05/04/2015 |
| Last Update Date | 05/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417334988 | NPI | - | NPPES |
| 091707 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 091707 (Wisconsin) | Primary |
H.s. Psychological Services Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: W243s7630 Evergreen Dr, Mukwonago, WI 53149 Phone: 262-662-1116 Fax: 262-662-1118 | |
Crossroad Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: S110w30520 Ymca Camp Rd, Mukwonago, WI 53149 Phone: 262-777-1833 Fax: 262-363-0973 | |
Shara Grover Md Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Eagle Lake Ave, Mukwonago, WI 53149 Phone: 262-363-5719 Fax: 262-363-9763 |