Organization
INNOVATIVE RECOVERY NETWORK OF WISCONSIN LLC
Active
Other names
Innovative Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD HEGEL (PRESIDENT)
(414) 383-4432
Entity
Organization
Contact information
Practice address
1314 W NATIONAL AVE, MILWAUKEE, WI 53204-2114
(414) 383-4432
(414) 383-4482
Mailing address
1314 W NATIONAL AVE, MILWAUKEE, WI 53204-2114
(414) 383-4432
(414) 383-4482
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
2961
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
10/06/2011
Last updated
05/08/2012
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