Organization
INTEGRATED DEVELOPMENTAL SERVICES, INC
Active
Parent organization
CARAVEL AUTISM HEALTH, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARAVEL AUTISM HEALTH, LLC
Authorized official
HEIDI LEE MORAGO (CREDENTIALING SPECIALIST)
(509) 954-9128
Entity
Organization
Contact information
Practice address
559 ZOR SHRINE PLACE, MADISON, WI 53719
(608) 441-0123
(608) 441-0126
Mailing address
1575 ALLOUEZ AVE, GREEN BAY, WI 54311-5639
(920) 857-9041
(920) 857-3366
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
WI
Other
Enumeration date
04/28/2006
Last updated
12/24/2019
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