Organization · Type 2 NPI

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Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Milwaukee, WI

NPI number 1336205855 Active

Practice location

2902 N 1st St
Milwaukee, WI 53212-2406

Call (414) 372-0739 Map

Fax (414) 372-0739

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000X9374 (WI)

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.

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About NPI 1336205855

Match's National Provider Identifier is 1336205855, issued on Dec 29, 2006. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Milwaukee, WI. The record was last updated on Aug 22, 2020.