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State Of Wisconsin
Intellectual Disabilities Intermediate Care Facility in Chippewa Falls, Wisconsin
NPI 1235225616

State Of Wisconsin is a Intellectual Disabilities Intermediate Care Facility based in Chippewa Falls, WI. State Of Wisconsin practices in Chippewa Falls, WI. The NPI Number for State Of Wisconsin is 1235225616 and holds a License No. 2753 (Wisconsin).

The current practice location address for State Of Wisconsin is 2820 East Park Avenue, Chippewa Falls, WI and can be reached out via phone at 715-723-7957.

Location: 2820 East Park Avenue, Chippewa Falls, WI, 54729-0340
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1235225616
Provider Name
State Of Wisconsin
Credential
Provider Entity Type
Organization
Address
2820 East Park Avenue, Chippewa Falls, WI, 54729-0340
Phone Number
715-723-7957
Fax Number
Provider Enumeration Date
10/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
21050200 05 WI
institution
Provider Business Practice Location Address Details
Address
2820 East Park Avenue
City
Chippewa Falls
State
Wisconsin
Zip
54729-0340
Phone Number
715-723-7957
Fax Number
person
Provider Business Mailing Address Details
Address
2820 East Park Avenue
City
Chippewa Falls
State
Wisconsin
Zip
54729-0340
Phone Number
715-723-7957
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
2753 (Wisconsin)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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