| A Village Llc | |
|
2031 E Calumet St Appleton WI 54915-4742 | |
| (920) 809-6766 | |
| Not Available |
| Full Name | A Village Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2031 E Calumet St, Appleton, Wisconsin |
| Authorized Official Name and Position | Teresa Gross (OWNER) |
| Authorized Official Contact | 9208096766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Village Llc Po Box 172 Appleton WI 54912-0172 Ph: (920) 809-6766 | A Village Llc 2031 E Calumet St Appleton WI 54915-4742 Ph: (920) 809-6766 |
| NPI Number | 1699233270 |
|---|---|
| Provider Enumeration Date | 03/04/2019 |
| Last Update Date | 03/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699233270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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