Jasen Eberhardt, SAC-IT

NPI 1376021782 · on the registry since 2018

Practice

Address: 223 Wisconsin Ave Ste B
Waukesha, WI 53186
Phone: (262) 701-7257
Organisation at this address: Solaris Recovery Llc
Sals Recovery Center Llc
Children'S Service Society Of Wisconsin
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Licence states on file: WI
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2018-07-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin