Organization
TELLURIAN, INC.
Active
Other names
Tellurian Outpatient Clinic, Tellurian UCAN Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY E CROOKS MSW (QUALITY ASSURANCE MANAGER)
(608) 663-2120
Entity
Organization
Contact information
Practice address
300 FEMRITE DR, MONONA, WI 53716-3716
(608) 222-7311
(608) 222-5904
Mailing address
300 FEMRITE DR, MONONA, WI 53716-3716
(608) 222-7311
(608) 222-5904
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
774
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39394400
—
WI
Enumeration date
04/09/2008
Last updated
08/15/2022
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