Organization
PRIMARY CONNECTION HEALTHCARE, INC.
Active
Parent organization
PRIMARY CONNECTION HEALTHCARE, INC.
Other names
Bridge Community Health Clinic Mental Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMARY CONNECTION HEALTHCARE, INC.
Authorized official
MS. LAURA SCUDIERE (EXECUTIVE DIRECTOR)
(715) 848-4884
Entity
Organization
Contact information
Practice address
1810 2ND ST, WAUSAU, WI 54403-3492
(715) 848-4884
(715) 845-5385
Mailing address
1810 2ND ST, WAUSAU, WI 54403-3492
(715) 848-4884
(715) 845-5385
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PENDING
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
OUTPATIENT MENTAL HEALTH CLINIC CERTIFICATION NUMBER
WI
05
—
PENDING
—
WI
Enumeration date
07/23/2009
Last updated
07/23/2009
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