Individual provider · Type 1 NPI
Renee M. Coleman
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Rice Lake, WI
Practice location
1971 21 15/16 St
Rice Lake, WI 54868-8583
Fax (715) 234-2122
Mailing address
1971 Country Aire Drive
Rice Lake, WI 54868
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| 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 1114172954
Renee M. Coleman's National Provider Identifier is 1114172954, issued on Nov 20, 2008. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Rice Lake, WI. The record was last updated on Nov 20, 2008.