institution
State Of Wisconsin
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Madison, Wisconsin
NPI 1588703078

State Of Wisconsin is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Madison, WI. State Of Wisconsin practices in Madison, WI. The NPI Number for State Of Wisconsin is 1588703078 and holds a License No. 1000-042 (Wisconsin).

The current practice location address for State Of Wisconsin is 317 Knutson Dr, Madison, WI and can be reached out via phone at 608-301-1946 and via fax at 608-301-1871.

Location: 317 Knutson Dr, Madison, WI, 53704-1133
institution
Provider Profile Details
NPI Number
1588703078
Provider Name
State Of Wisconsin
Credential
Provider Entity Type
Organization
Address
317 Knutson Dr, Madison, WI, 53704-1133
Phone Number
608-301-1946
Fax Number
608-301-1871
Provider Enumeration Date
02/05/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5106770 01 WI NCPDP
institution
Provider Business Practice Location Address Details
Address
317 Knutson Dr
City
State
Zip
53704-1133
Phone Number
608-301-1946
Fax Number
608-301-1871
person
Provider Business Mailing Address Details
Address
317 Knutson Dr
City
State
Zip
53704-1133
Phone Number
608-301-1946
Fax Number
608-301-1871
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
1000-042 (Wisconsin)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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