Healthcare Provider Details
I. General information
NPI: 1366328320
Provider Name (Legal Business Name): DEER PATH INTEGRATED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2025
Last Update Date: 09/27/2025
Certification Date: 09/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
N9895 18TH AVE
NECEDAH WI
54646-8056
US
IV. Provider business mailing address
PO BOX 10
NECEDAH WI
54646-0010
US
V. Phone/Fax
- Phone: 608-565-3700
- Fax: 608-572-7997
- Phone: 608-565-3700
- Fax: 608-572-7997
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERICA
FALK-HUZAR
Title or Position: PRESIDENT
Credential: PSYD
Phone: 608-547-4444