# NORTHWOODS BEHAVIORAL HEALTH CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508125618
- **Authorized official:** RUTH A MULLINS M.S. (LICENSED PSYCHOTHERAPIST)
- **Authorized official phone:** (920) 217-7910

## Contact information

- **Practice address:** 600 W BROAD ST, CRANDON, WI 54520-1170
- **Practice address phone:** (920) 217-7910
- **Mailing address:** 600 W BROAD ST, CRANDON, WI 54520-1170
- **Mailing address phone:** (920) 217-7910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 1714-125 | WI | Yes |

## Other

- **Enumeration date:** 05/09/2012
- **Last updated:** 05/09/2012