Open Space LLC
Counselor, Professional in Madison, WI. Organization (NPI-2).
NPI number1194553404
StatusActive
Last updated in NPPESJul 26, 2024
Details
- NPI
- 1194553404
- Entity type
- Organization (NPI-2)
- Legal business name
- Open Space LLC
- Organization subpart
- No
- Enumeration date
- Jul 26, 2024
- Certification date
- Jul 26, 2024
- Last updated
- Jul 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
Other names
- Open Space LLC (Doing Business As)
Practice location
402 Gammon Pl Ste 290Madison, WI 53719-1075
Phone 608-370-9063
Mailing address
4801 Tocora LnMadison, WI 53711-1222
Phone 608-370-9063
Authorized official
Sara Jordan
Owner/Director
6083709063
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