Organization
WOOD VIOLET RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN VANHOOSER MHA, CPHQ (DIRECTOR OF COMPLIANCE)
(949) 750-2014
Entity
Organization
Contact information
Practice address
3591 STATE HWY 23, DODGEVILLE, WI 53533
(949) 988-0471
(949) 325-7818
Mailing address
DEPT#880745 PO BOX 29650, PHOENIX, AZ 85038-9650
(949) 988-0471
(949) 325-7818
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/01/2024
Last updated
11/04/2024
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