Provider Demographics
NPI:1154670321
Name:SUPERIOR TREATMENT CENTER, INC
Entity Type:Organization
Organization Name:SUPERIOR TREATMENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAAFLADT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-392-9300
Mailing Address - Street 1:1507 TOWER AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880
Mailing Address - Country:US
Mailing Address - Phone:715-392-9300
Mailing Address - Fax:715-392-8041
Practice Address - Street 1:1507 TOWER AVE STE 307
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880
Practice Address - Country:US
Practice Address - Phone:715-392-9300
Practice Address - Fax:715-392-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1926251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health