Organization
AADVANTAGE BEHAVIORAL HEALTHCARE, LLC
Active
Other names
Advantage Behavioral Healthcare, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN GALE BUSS (EXECUTIVE DIRECTOR)
(608) 843-4555
Entity
Organization
Contact information
Practice address
125 E PINE ST, LAKE MILLS, WI 53551-1103
(608) 843-4555
Mailing address
N6658 WOODFIELD LN, LAKE MILLS, WI 53551-9740
(608) 843-4555
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6647-123
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
2498
WI
261QM0850X
Adult Mental Health Clinic/Center
6647-123
WI
261QM0855X
Adolescent and Children Mental Health Clinic/Center
6647-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42236300
—
WI
Enumeration date
07/15/2009
Last updated
07/15/2009
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