Organization
AGNESIAN HEALTHCARE INC
Active
Other names
SSM Health Treffert Center Autism Services
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH R MINERATH (SYSTEM DIRECTOR - GOV'T REIMB.)
(608) 445-2411
Entity
Organization
Contact information
Practice address
371 E 1ST ST, FOND DU LAC, WI 54935-4563
(920) 907-3967
Mailing address
40 CAMELOT DR, FOND DU LAC, WI 54935-8049
(920) 907-8201
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2226
WI
Other
Enumeration date
06/27/2017
Last updated
01/30/2025
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