Organization
HUMAN DEVELOPMENT ASSOCIATES OF LACROSSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN KREUZER LICSW (CORPORATION MEMBER)
(608) 784-8688
Entity
Organization
Contact information
Practice address
2920 EAST AVE S, SUITE 101, LACROSSE, WI 54601-8282
(608) 784-8688
(608) 784-8684
Mailing address
2920 EAST AVE S, SUITE 101, LACROSSE, WI 54601-8282
(608) 784-8688
(608) 784-8684
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1425
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42125000
—
WI
Enumeration date
01/30/2007
Last updated
08/22/2020
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