Organization
LIVING WELL CHRISTIAN FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMI JO LIPPS MS (OWNER)
(608) 783-1452
Entity
Organization
Contact information
Practice address
575 LESTER AVE STE 100, ONALASKA, WI 54650-8695
(608) 783-1452
Mailing address
575 LESTER AVE STE 100, ONALASKA, WI 54650-8695
(608) 783-1452
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42253100
—
WI
Enumeration date
02/20/2008
Last updated
10/07/2020
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