Organization
FAMILY SERVICE OF RACINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KATIE L. OATSVALL (EXECUTIVE DIRECTOR)
(262) 634-2391
Entity
Organization
Contact information
Practice address
420 7TH STREET, RACINE, WI 53403-1222
(262) 634-2391
(262) 634-5342
Mailing address
420 7TH STREET, RACINE, WI 53403-1222
(262) 634-2391
(262) 634-5342
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1339
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42128100
—
WI
Enumeration date
04/26/2006
Last updated
06/26/2020
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