Organization
AGNESIAN HEALTHCARE, INC
Active
Parent organization
AGNESIAN HEALTHCARE, INC
Other names
SSM HEALTH BEHAVIORAL HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
AGNESIAN HEALTHCARE, INC
Authorized official
BONNIE R SCHMITZ (CFO)
(920) 926-4480
Entity
Organization
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 929-2300
(920) 926-8885
Mailing address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 929-2300
(920) 926-8885
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101159
VESTICA
WI
05
—
11013000
—
WI
01
—
547140
DEAN CARE
WI
Enumeration date
01/06/2006
Last updated
03/12/2022
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