Provider Demographics
NPI:1881850865
Name:RICHARD YANCHAR, PH.D., S.C.
Entity type:Organization
Organization Name:RICHARD YANCHAR, PH.D., S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:YANCHAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:262-646-6404
Mailing Address - Street 1:394 WILLIAMSTOWNE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2322
Mailing Address - Country:US
Mailing Address - Phone:262-646-6404
Mailing Address - Fax:262-646-6405
Practice Address - Street 1:394 WILLIAMSTOWNE
Practice Address - Street 2:SUITE 202
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2322
Practice Address - Country:US
Practice Address - Phone:262-646-6404
Practice Address - Fax:262-646-6405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health