Healthcare Provider Details

I. General information

NPI: 1740355452
Provider Name (Legal Business Name): LUTHERAN SOCIAL SERVICES OF WISCONSIN AND UPPER MICHIGAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3136 CRAIG RD
EAU CLAIRE WI
54701-6109
US

IV. Provider business mailing address

6737 W WASHINGTON ST STE 2275
WEST ALLIS WI
53214-5666
US

V. Phone/Fax

Practice location:
  • Phone: 715-385-9110
  • Fax:
Mailing address:
  • Phone: 414-246-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: TARA TREGLOWNE
Title or Position: COO
Credential:
Phone: 414-246-2300