Organization · Type 2 NPI
Lad Lake, Inc.
Emotionally Disturbed Childrens' Residential Treatment Facility · Dousman, WI
NPI number
1114196854
Active
Practice location
W350S1401 Waterville Rd
Dousman, WI 53118-9020
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | NONE (WI) |
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | 265001 (WI) |
Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
7 other providers at this address
- Dennis James Neuenfeldt, LCSW, LMFTClinical Social Worker Dousman, WI NPI 1356515126
- Edward Michael Smith, LPC-ITMental Health Counselor Dousman, WI NPI 1548892821
- George Vohwinkle, LCSWClinical Social Worker Dousman, WI NPI 1063686210
- Maraleta SwensonClinical Social Worker Dousman, WI NPI 1467626762
- Mary Bachman, RNRegistered Nurse Dousman, WI NPI 1447424163
- Rebecca Barnes, APNPPsychiatric/Mental Health Nurse Practitioner Dousman, WI NPI 1780121699
- Steve EllmannRehabilitation Psychologist Dousman, WI NPI 1801060199
About NPI 1114196854
Lad Lake, Inc.'s National Provider Identifier is 1114196854, issued on Feb 27, 2008. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Dousman, WI. The record was last updated on Feb 27, 2008.