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Organization
OPEN DOOR CENTER FOR CHANGE LLC
Active
Organization
OPEN DOOR CENTER FOR CHANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY J MOSHER-GARVEY LCSW, CSAC (CO-OWNER)
(608) 827-7220
Entity
Organization
Contact information
Practice address
6502 GRAND TETON PLZ STE 102, MADISON, WI 53719-1047
(608) 827-7220
(608) 827-7223
Mailing address
6502 GRAND TETON PLZ STE 102, MADISON, WI 53719-1047
(608) 827-7220
(608) 827-7223
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42198900
—
WI
Enumeration date
03/07/2007
Last updated
03/07/2024
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