Organization
RACINE COUNTY CCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE GOGGINS (ADULT SERVICES MANAGER)
(262) 638-6633
Entity
Organization
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-7719
Mailing address
1717 TAYLOR AVE, RACINE, WI 53403-2405
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3031
WI
Other
Enumeration date
10/29/2014
Last updated
03/30/2015
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