| NPI | 1578153003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MINNING Director Of Treasury 920-206-4459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2022-06-09 |