Provider Demographics
NPI:1194694356
Name:DEER PATH INTEGRATED LIVING, INC.
Entity type:Organization
Organization Name:DEER PATH INTEGRATED LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FALK-HUZAR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, SAC, CNHP
Authorized Official - Phone:608-547-4444
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:NECEDAH
Mailing Address - State:WI
Mailing Address - Zip Code:54646-0010
Mailing Address - Country:US
Mailing Address - Phone:608-621-7015
Mailing Address - Fax:608-572-7997
Practice Address - Street 1:N9895 18TH AVE
Practice Address - Street 2:
Practice Address - City:NECEDAH
Practice Address - State:WI
Practice Address - Zip Code:54646-8056
Practice Address - Country:US
Practice Address - Phone:608-621-7015
Practice Address - Fax:608-572-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-04
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)