Provider First Line Business Practice Location Address:
1320 WISCONSIN AVE
Provider Second Line Business Practice Location Address:
MENTAL HEALTH AND ADDICTION CARE
Provider Business Practice Location Address City Name:
RACINE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53403-1978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-687-2722
Provider Business Practice Location Address Fax Number:
262-687-2499
Provider Enumeration Date:
04/10/2008