Organization
COULEE YOUTH CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN T. EIDE CSW (EXECUTIVE DIRECTOR)
(608) 782-7152
Entity
Organization
Contact information
Practice address
231 COPELAND AVE, LA CROSSE, WI 54603-3086
(608) 782-7152
(608) 785-1241
Mailing address
231 COPELAND AVE, P.O.BOX 1836, LA CROSSE, WI 54603-3086
(608) 782-7152
(608) 785-1241
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1241
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42164300
—
WI
Enumeration date
08/24/2007
Last updated
04/24/2008
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