Provider Demographics
NPI:1184182602
Name:SYMETRIA HEALTH OF WISCONSIN, L.L.C.
Entity Type:Organization
Organization Name:SYMETRIA HEALTH OF WISCONSIN, L.L.C.
Other - Org Name:SYMETRIA RECOVERY OF MADISON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-782-6966
Mailing Address - Street 1:40 SHUMAN BLVD STE 262
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8480
Mailing Address - Country:US
Mailing Address - Phone:888-782-6966
Mailing Address - Fax:630-870-1284
Practice Address - Street 1:2997 YARMOUTH GREENWAY DR STE 100
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5809
Practice Address - Country:US
Practice Address - Phone:888-782-6966
Practice Address - Fax:630-870-1284
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOFT LANDING INTERVENTIONS, L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-04
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder