Organization
BETHANY CHRISTIAN SERVICES
Active
Parent organization
BETHANY CHRISTIAN SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
BETHANY CHRISTIAN SERVICES
Authorized official
LISA STOUTMEYER (BILLER)
(616) 224-7429
Entity
Organization
Contact information
Practice address
1331 CAPITOL DR, OCONOMOWOC, WI 53066-5705
(262) 547-6557
(262) 547-3644
Mailing address
1331 CAPITOL DR, OCONOMOWOC, WI 53066-5705
(262) 547-6557
(262) 547-3644
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
205-121
WI
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/26/2013
Last updated
07/12/2021
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