Organization Name: | AADVANTAGE BEHAVIORAL HEALTHCARE, LLC |
NPI Number: | 1669602488 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MAUREEN GALE BUSS (EXECUTIVE DIRECTOR) |
Mailing Address: | 125 E Pine St Lake Mills |
State: | WI US |
Postal Code: | 535511103 |
Phone Number: | 6088434555 |
Fax Number: | |
NPI Enumeration Date: | 07/15/2009 |
NPI Last Update Date: | 07/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 2498 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |