Wisconsin Eating Disorder Specialists Sc

LBN: Wisconsin Eating Disorder Specialists Sc
Wisconsin Eating Disorder Specialists Sc is an health care organization with primary practice located at 34700 Valley Rd , Oconomowoc WI 53066-4500. The organization recently has only one registered license in Hospitals / Psychiatric Hospital, which is considered as the primary health care specialty. Wisconsin Eating Disorder Specialists Sc can be contacted via phone (262) 646-1387, or through Weltzin, Theodore via phone (262) 646-4411.

Contact Information

Primary practice address
34700 Valley Rd Oconomowoc WI 53066-4500
Phone: (262) 646-1387
Fax: (262) 646-7067
Website:
Map and Directions
Authorized official contact:
Name: Weltzin, Theodore Doctor of Medicine (MD)
Phone: (262) 646-4411

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Psychiatric Hospital 283Q00000X

Profile Details

NPI number 1801807375
LBN Legal business name Wisconsin Eating Disorder Specialists Sc
DBA Doing business as
Authorized official Weltzin, Theodore Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801807375 NPPES
Wisconsin MEDICAID 21282400

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