Individual provider · Type 1 NPI
Chelsae Wagner
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Wyoming, IA
Practice location
8005 County Road E45
Wyoming, IA 52362-7514
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility (Mental Illness) | 3104A0625X | None listed |
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | None listed |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | None listed |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1003566985
Chelsae Wagner's National Provider Identifier is 1003566985, issued on Mar 24, 2022. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Wyoming, IA. The record was last updated on Mar 24, 2022.