| NPI | 1396676714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QADAR ISSE Manager 608-515-9533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2026-05-26 |
| Last Update Date | 2026-05-26 |