Organization
ADVANCED THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH LAYDEN LSW (OWNER)
(262) 506-4050
Entity
Organization
Contact information
Practice address
4402 S 68TH ST, STE104, GREENFIELD, WI 53220-3479
(262) 506-4050
Mailing address
4402 S. 68TH ST., STE104, GREENFEILD, WI 53220
(262) 506-4050
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2417-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295856219
—
WI
Enumeration date
12/30/2016
Last updated
12/30/2016
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