Organization
DANE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATTY HILLEBRAND (ACCOUNTANT)
(608) 242-6206
Entity
Organization
Contact information
Practice address
1202 NORTHPORT DR, MADISON, WI 53704-2020
(608) 242-6206
(608) 242-6246
Mailing address
1202 NORTHPORT DR, MADISON, WI 53704-2020
(608) 242-6206
(608) 242-6246
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69004200
—
WI
Enumeration date
09/11/2007
Last updated
09/11/2007
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