Life Skills Support Center of Eau Claire, Ltd.
NPI #1124225503 in Eau Claire, Wisconsin
Provider Information
- NPI Number
- 1124225503
- Entity Type
- Organization
- Organization Name
- Life Skills Support Center of Eau Claire, Ltd.
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Enumeration Date
- Jun 29, 2007
- Last Updated
- Jul 18, 2007
Practice Location
- Address
- 4907 KEYSTONE XING
- City
- Eau Claire
- State
- Wisconsin
- ZIP Code
- 54701-5144
- Phone
- (505) 730-2947
Authorized Official
- Name
- DR. NINO A VIDIC, MD
- Title
- OWNER
- Phone
- (505) 730-2947
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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