Organization
TRIVIUM LLC
Active
Other names
CROSSROADS COUNSELING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY PERRY LCSW (ADMINISTRATOR)
(608) 755-5260
Entity
Organization
Contact information
Practice address
17 S RIVER ST, JANESVILLE, WI 53548-3860
(608) 755-5260
(608) 755-5267
Mailing address
17 S RIVER ST, JANESVILLE, WI 53548-3860
(608) 755-5260
(608) 755-5267
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1265
WI
261QM0850X
Adult Mental Health Clinic/Center
1265
WI
261QM0855X
Adolescent and Children Mental Health Clinic/Center
1265
WI
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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