Organization
RIDGEWOOD RECOVERY, INC.
Active
Other names
The Superior Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY M FETSCH (DIRECTOR)
(715) 392-9300
Entity
Organization
Contact information
Practice address
1507 TOWER AVE, SUITE 307, SUPERIOR, WI 54880-2532
(715) 392-9300
(715) 392-8041
Mailing address
1507 TOWER AVE, SUITE 307, SUPERIOR, WI 54880-2532
(715) 392-9300
(715) 392-8041
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
OUTPATIENT-1926
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
1926
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42252200
—
WI
Enumeration date
04/16/2007
Last updated
05/06/2014
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