Organization
GATEHOUSE PSYCHIATRIC SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY C EXTEROVICH (CHIEF OPERATING OFFICER)
(608) 963-0674
Entity
Organization
Contact information
Practice address
201 8TH AVE STE 12, BARABOO, WI 53913-2112
(608) 434-2177
Mailing address
PO BOX 353, BARABOO, WI 53913-0353
(608) 434-2177
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/10/2021
Last updated
03/15/2021
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