Organization
LUTHERAN SOCIAL SERVICES OF UPPER MICHIGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKY ANN THULL SAC-IT (SUBSTANCE ABUSE COUNSELOR-I T)
(920) 924-5222
Entity
Organization
Contact information
Practice address
131 S,. MAIN STREET, FOND DU LAC, WI 54935
(920) 730-1349
(920) 724-2824
Mailing address
3003 B N. RICHMOND STREET, APPLETON, WI 54911-1148
(920) 730-1349
(920) 724-2824
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
15448-130
WI
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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