Organization
VITALITY YOUTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEE RAE GLOWACKI MA (OWNER)
(608) 293-0014
Entity
Organization
Contact information
Practice address
726 12TH AVE, MONROE, WI 53566-1435
(608) 293-0014
Mailing address
726 12TH AVE, MONROE, WI 53566-1435
(608) 293-0014
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/27/2020
Last updated
05/27/2020
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