Organization · NPI-2

Family Service Of Racine

Counselor, Mental Health · Racine, WI

NPI number1467419200
StatusActive
Last updated in NPPESJun 26, 2020

Details

NPI
1467419200
Entity type
Organization (NPI-2)
Legal business name
Family Service Of Racine
Organization subpart
No
Enumeration date
Apr 26, 2006
Certification date
Jun 26, 2020
Last updated
Jun 26, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health1339WIYes
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––

Practice location

420 7th Street
Racine, WI 53403-1222

Phone 262-634-2391 · Fax 262-634-5342

Mailing address

420 7th Street
Racine, WI 53403-1222

Phone 262-634-2391 · Fax 262-634-5342

Authorized official

Katie L. Oatsvall
Executive Director
2626342391

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