Provider First Line Business Practice Location Address:
CENTER 4820 N SHERMAN ROAD
Provider Second Line Business Practice Location Address:
WINNEBAGO CORRECTION CENTER, DRUG ABUSE CORRECTIONAL
Provider Business Practice Location Address City Name:
WINNEBAGO
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54985-0036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-236-2700
Provider Business Practice Location Address Fax Number:
920-426-5601
Provider Enumeration Date:
10/24/2017