Organization
PREVAIL BEHAVIORAL HEALTH SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMILY L RUSS PA (OWNER)
(920) 475-0333
Entity
Organization
Contact information
Practice address
15 PARK PL STE 200, APPLETON, WI 54914-8250
(920) 475-0333
Mailing address
15 PARK PL STE 200, APPLETON, WI 54914-8250
(920) 475-0333
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/03/2023
Last updated
06/07/2024
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