| NPI | 1669618864 |
|---|---|
| Other Name | FAITH VILLAGE III |
| Entity Type | Organization |
| Authorized Contact | JEFFREY A. KACZMARSKI VP Of Legal Affairs 920-206-4406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2013-02-05 |