Organization
IRONWOOD MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA VAN GORDEN (OWNER)
(262) 300-4948
Entity
Organization
Contact information
Practice address
403 N GRAND AVE # 101, WAUKESHA, WI 53186-4984
(262) 300-4948
Mailing address
403 N GRAND AVE # 101, WAUKESHA, WI 53186-4984
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
03/07/2024
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