Organization
JANESVILLE PSYCHIATRIC CLINIC DAYTREATMENT FOR CHILDREN
Active
Parent organization
JANESVILLE PSYCHIATIC CLINIC MAIN INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JANESVILLE PSYCHIATIC CLINIC MAIN INC
Authorized official
MR. WILLIAM HOLLINGSWORTH (DIRECTOR/OWNER)
(608) 755-1475
Entity
Organization
Contact information
Practice address
2640 MILTON AVE, JANESVILLE, WI 53545-0231
(608) 755-1475
(608) 755-1733
Mailing address
2640 MILTON AVE, JANESVILLE, WI 53545-0231
(608) 755-1475
(608) 755-1733
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1448
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43007200
—
WI
Enumeration date
04/18/2008
Last updated
04/18/2008
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