| NPI | 1679364376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDIFITAH M ADOW Manager 608-772-8036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-05-14 |