Organization
SWEETGRASS BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEGRA FOWLER LCSW (OWNER)
(715) 280-8130
Entity
Organization
Contact information
Practice address
102 E GREEN BAY ST STE 101, SHAWANO, WI 54166-2444
(715) 280-8130
(715) 280-8138
Mailing address
102 E GREEN BAY ST STE 101, SHAWANO, WI 54166-2444
(715) 280-8130
(715) 280-8138
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
12/20/2022
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