| NPI | 1053747386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM C REYNOLDS Bishop 608-630-0617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2014-01-02 |