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1770012254
AMBER MALL
MADISON, WI
NPI
1770012254
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-06-08
Last Update Date
2017-06-08
Business Address
AMBER MALL SAC-IT
151 E BADGER RD
MADISON, WI 53713-2708
Phone number: 608-250-2512
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Mailing Address
AMBER MALL SAC-IT
212 14TH AVE
NEW GLARUS, WI 53574-9703
Phone number: 608-219-5347
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