Organization
COULEE COUNCIL ON ADDICTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA RUDA (EXECUTIVE DIRECTOR)
(608) 784-4177
Entity
Organization
Contact information
Practice address
921 WEST AVE S, LA CROSSE, WI 54601-4745
(608) 784-4177
(608) 784-6302
Mailing address
921 WEST AVE S, LA CROSSE, WI 54601-4745
(608) 784-4177
(608) 784-6302
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1240
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42230400
—
WI
Enumeration date
11/09/2011
Last updated
11/09/2011
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