Organization
WISCONSIN LUTHERAN CHILD & FAMILY SERVICE INC
Active
Other names
Christian Family Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA M RANGEL (INSURANCE PROVIDER COORDINATOR)
(262) 345-5533
Entity
Organization
Contact information
Practice address
112 PEACE LUTHERAN PKWY, HARTFORD, WI 53027-1159
(800) 438-1772
(262) 293-9737
Mailing address
W175N11120 STONEWOOD DR, GERMANTOWN, WI 53022-6511
(800) 438-1772
(262) 293-9737
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000084585
MEDICARE GROUP ID -P TAN
WI
05
—
42223600
—
WI
Enumeration date
11/07/2006
Last updated
08/18/2016
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