Organization
TELLURIAN, INC.
Active
Other names
Tellurian UCAN, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN FLOREK (CEO)
(608) 663-2120
Entity
Organization
Contact information
Practice address
414 BROADWAY ST, SUITE 101, BARABOO, WI 53913-2488
(608) 402-4312
(608) 355-0459
Mailing address
414 BROADWAY ST, SUITE 101, BARABOO, WI 53913-2488
(608) 402-4312
(608) 355-0459
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3127
WI
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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