Organization · Type 2 NPI
Country Grove Home LLC
Assisted Living Facility (Mental Illness) · Necedah, WI
Practice location
N11151 17th Ave
Necedah, WI 54646-7619
Mailing address
N10414 18th Ave
Necedah, WI 54646-7934
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility (Mental Illness) Primary | 3104A0625X | 0011011 (WI) |
Assisted Living Facility (Mental Illness): A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
About NPI 1306162706
Country Grove Home LLC's National Provider Identifier is 1306162706, issued on Apr 12, 2010. The primary taxonomy on file is Assisted Living Facility (Mental Illness) (3104A0625X), and the practice location is in Necedah, WI. The record was last updated on Apr 12, 2010.