Organization · Type 2 NPI

Platteville Family Resource Center

Mental Illness Community Based Residential Treatment Facility · Platteville, WI

NPI number 1104207497 Active

Practice location

155 W Lewis St
Platteville, WI 53818-2103

Call (608) 642-1563 Map

Fax (608) 348-4191

Mailing address

PO Box 36
Platteville, WI 53818-0036

Specialties and licenses

Taxonomy	Code	License
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	None listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

NPI record

NPI: 1104207497
Entity type: Organization (Type 2)
Issued: Jun 12, 2015
Last updated: Aug 4, 2015
Status: Active
Subpart: Yes of Platteville Family Resource Center

Other names

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SW Wi Regional Elem Therapeutic Classroom · doing business as

Authorized official

Dr. Marc Wruble, PhD
Director
(608) 348-4060

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104207497

Platteville Family Resource Center's National Provider Identifier is 1104207497, issued on Jun 12, 2015. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Platteville, WI. The record was last updated on Aug 4, 2015.