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Organization
MENTELLA OF WISCONSIN SC
Active
Organization
MENTELLA OF WISCONSIN SC
Active
Other names
Mentella Health
Organization subpart
No
Provider details
NPI number
Authorized official
JILL VANCE PSYD (CEO)
(872) 205-0456
Entity
Organization
Contact information
Practice address
680 N LAKE SHORE DR STE 110-1113, CHICAGO, IL 60611-4546
(872) 205-0456
Mailing address
680 N LAKE SHORE DR STE 110-1113, CHICAGO, IL 60611-4546
(872) 205-0456
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/06/2025
Last updated
09/06/2025
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