institution
State Of Wisconsin
Psychiatric Hospital in Winnebago, Wisconsin
NPI 1164516506

State Of Wisconsin is a Psychiatric Hospital based in Winnebago, WI. State Of Wisconsin practices in Winnebago, WI. The NPI Number for State Of Wisconsin is 1164516506 and holds a License No. 250 (Wisconsin).

The current practice location address for State Of Wisconsin is 1300 South Drive, Winnebago, WI and can be reached out via phone at 920-235-4910 and via fax at 920-237-2043.

Location: 1300 South Drive, Winnebago, WI, 54985-0009
institution
Provider Profile Details
NPI Number
1164516506
Provider Name
State Of Wisconsin
Credential
Provider Entity Type
Organization
Address
1300 South Drive, Winnebago, WI, 54985-0009
Phone Number
920-235-4910
Fax Number
920-237-2043
Provider Enumeration Date
10/02/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
10063000 05 WI
institution
Provider Business Practice Location Address Details
Address
1300 South Drive
City
State
Zip
54985-0009
Phone Number
920-235-4910
Fax Number
920-237-2043
person
Provider Business Mailing Address Details
Address
1300 South Drive
City
State
Zip
54985-0009
Phone Number
920-235-4910
Fax Number
920-237-2043
person
Provider's Taxonomy Details 1
Type
Hospitals
Classification
Psychiatric Hospital
Speciality
-
Taxonomy
License No.
250 (Wisconsin)
Definition
An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.
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