NPI 1285844480

Glen Haven Counseling Clinic

Organisation Community/Behavioral Health Agency Glendale, WI

Practice location

Address: 6270 N Port Washington Rd Suite 201, Glendale, WI 53217-4311
Phone: (414) 962-2284

Authorised official

Name: Jerrold Bernard Rousseau
Title: Owner
Phone: (414) 962-2284

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 1384 (WI)

Other Community/Behavioral Health providers in Wisconsin →

Registry record

NPI: 1285844480
Entity type: Organization
NPI issued: 23 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.