Organization
SHEBOYGAN COMPREHENSIVE TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARY TAUCHMAN M.D. (MEDICAL DIRECTOR)
(920) 458-6527
Entity
Organization
Contact information
Practice address
2842 S BUSINESS DR, SHEBOYGAN, WI 53081-6518
(920) 458-6527
Mailing address
W1781 PUDDLEFORT ST, MOUNT CALVARY, WI 53057-9714
(920) 904-3533
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
16934-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
WI
Enumeration date
06/06/2016
Last updated
06/06/2016
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