| NPI | 1700466588 |
|---|---|
| Doing Business As | WILLOW RIDGE CBRF |
| Entity Type | Organization |
| Authorized Contact | LESLIE COBURN Lead Account Clerk 715-538-4312 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-04-14 |