Organization
NORTHLAND COMMUNITY SERVICES CRISIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON S MATTHEW (DIRECTOR)
(608) 296-2139
Entity
Organization
Contact information
Practice address
161 SPRING ST, WESTFIELD, WI 53964-9068
(608) 296-2139
Mailing address
161 SPRING ST, WESTFIELD, WI 53964-9068
(608) 296-2139
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1693
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32977000
—
WI
Enumeration date
05/23/2008
Last updated
05/28/2008
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