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Organization
LIVING WELL CHRISTIAN FAMILY CLINIC, LLC
Active
Organization
LIVING WELL CHRISTIAN FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMI JO LIPPS MS (OWNER)
(608) 783-1452
Entity
Organization
Contact information
Practice address
575 LESTER AVE STE 100, ONALASKA, WI 54650-8695
(608) 783-1452
Mailing address
575 LESTER AVE STE 100, ONALASKA, WI 54650-8695
(608) 783-1452
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42253100
—
WI
Enumeration date
02/20/2008
Last updated
10/07/2020
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