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Organization

RECONNECTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. B. HAL DESSEL LCSW, CADC III (OWNER, CLINIC DIRECTOR)
(414) 221-9293
Entity
Organization

Contact information

Practice address
921 W GLENDALE AVE, GLENDALE, WI 53209-6513
(414) 221-9293
(414) 221-9532
Mailing address
921 W GLENDALE AVE, GLENDALE, WI 53209-6513
(414) 221-9293
(414) 221-9532

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1775
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42211500
WI
Enumeration date
02/07/2007
Last updated
06/23/2008
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