Organization
PROFESSIONAL RECOVERY NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES JOHN ENGEL MD (PRESIDENT)
(262) 549-6600
Entity
Organization
Contact information
Practice address
2422 NORTH GRANDVIEW BLVD, WAUKESHA, WI 53188
(262) 549-6600
(262) 549-6698
Mailing address
2422 NORTH GRANDVIEW BLVD, WAUKESHA, WI 53188
(262) 549-6600
(262) 549-6698
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
1747
WI
324500000X
Substance Abuse Rehabilitation Facility
Primary
1748
WI
Other
Enumeration date
05/17/2007
Last updated
08/22/2020
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