| Organization Name: | ATTIC CORRECTIONAL SERVCIES |
| NPI Number: | 1598058562 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK WAKEFIELD (DEVELOPMENT QUALITY ASSURANCE OFFIC) |
| Mailing Address: | 1699 Schofield Ave Ste 116 Schofield |
| State: | WI US |
| Postal Code: | 544762377 |
| Phone Number: | 7153550671 |
| Fax Number: | |
| NPI Enumeration Date: | 05/24/2011 |
| NPI Last Update Date: | 05/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 15641-131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |