Provider Demographics
NPI:1922687540
Name:JOURNEY TO WHOLENESS, LLC
Entity Type:Organization
Organization Name:JOURNEY TO WHOLENESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:715-428-2082
Mailing Address - Street 1:N5405 COUNTY ROAD A
Mailing Address - Street 2:
Mailing Address - City:PRENTICE
Mailing Address - State:WI
Mailing Address - Zip Code:54556-9432
Mailing Address - Country:US
Mailing Address - Phone:715-428-2082
Mailing Address - Fax:715-428-2092
Practice Address - Street 1:N5405 COUNTY ROAD A
Practice Address - Street 2:
Practice Address - City:PRENTICE
Practice Address - State:WI
Practice Address - Zip Code:54556-9432
Practice Address - Country:US
Practice Address - Phone:715-428-2082
Practice Address - Fax:715-428-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)