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Organization
MIDWEST ADDICTION TREATMENT SERVICES LLC
Active
Organization
MIDWEST ADDICTION TREATMENT SERVICES LLC
Active
Other names
mats
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CESAR A COBARRUVIAS DO (CMO)
(715) 807-7917
Entity
Organization
Contact information
Practice address
450 S GREEN AVE, NEW RICHMOND, WI 54017
(715) 807-7917
Mailing address
450 S GREEN AVE, NEW RICHMOND, WI 54017
(715) 807-7917
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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