Provider Demographics
NPI:1477661692
Name:PLATTEVILLE FAMILY RESOURCE CENTER INC
Entity Type:Organization
Organization Name:PLATTEVILLE FAMILY RESOURCE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:WRUBLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:608-348-4060
Mailing Address - Street 1:1250 E BUSINESS HWY 151
Mailing Address - Street 2:STE D
Mailing Address - City:PLATTEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53818
Mailing Address - Country:US
Mailing Address - Phone:608-348-4060
Mailing Address - Fax:608-348-4191
Practice Address - Street 1:1250 E BUSINESS HWY 151
Practice Address - Street 2:STE D
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818
Practice Address - Country:US
Practice Address - Phone:608-348-4060
Practice Address - Fax:608-348-4191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)