Organization
LAKE MONONA PSYCHOTHERAPY & RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET J CREMIN MSW, RADCI (OFFICE MANAGER)
(608) 256-5030
Entity
Organization
Contact information
Practice address
900 JOHN NOLEN DR, SUITE 100, MADISON, WI 53713-1465
(608) 256-5030
(608) 256-5038
Mailing address
900 JOHN NOLEN DR, SUITE 100, MADISON, WI 53713-1465
(608) 256-5030
(608) 256-5038
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42147700
—
WI
Enumeration date
10/17/2006
Last updated
08/22/2020
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