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State Of Wisconsin
Intellectual Disabilities Intermediate Care Facility in Madison, Wisconsin
NPI 1336324946

State Of Wisconsin is a Intellectual Disabilities Intermediate Care Facility based in Madison, WI. State Of Wisconsin practices in Madison, WI. The NPI Number for State Of Wisconsin is 1336324946 and holds a License No. (Wisconsin).

The current practice location address for State Of Wisconsin is 317 Knutson Dr, Madison, WI and can be reached out via phone at 608-301-9382.

Location: 317 Knutson Dr, Madison, WI, 53704-1133
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1336324946
Provider Name
State Of Wisconsin
Credential
Provider Entity Type
Organization
Address
317 Knutson Dr, Madison, WI, 53704-1133
Phone Number
608-301-9382
Fax Number
Provider Enumeration Date
01/02/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
41225300 05 WI
institution
Provider Business Practice Location Address Details
Address
317 Knutson Dr
City
Madison
State
Wisconsin
Zip
53704-1133
Phone Number
608-301-9382
Fax Number
person
Provider Business Mailing Address Details
Address
317 Knutson Dr
City
Madison
State
Wisconsin
Zip
53704-1133
Phone Number
608-301-9382
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
()
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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