| NPI | 1265587356 |
|---|---|
| Doing Business As | BETHESDA FAITH VILLAGE |
| Entity Type | Organization |
| Authorized Contact | JEFFREY A. KACZMARSKI Chief Legal Affairs Officer 920-206-4406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: KS 1141302101) |
| Additional Taxonomies | 251B00000X Case Management (Licence: KS 0841302101) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2017-05-11 |