STATE OF WISCONSIN NPI 1588703078

NPI Information

STATE OF WISCONSIN is a residential treatment facility, intellectual and/or developmental disabilities in Madison, WI. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. STATE OF WISCONSIN NPI is 1588703078. The provider is registered as an organization entity type.
The provider Is Doing Business As Central Wisconsin Center Pharmacy Department.

The provider's business location address is:

317 KNUTSON DR
MADISON, WI
ZIP 53704-133
Phone: (608) 301-1946
Fax: (608) 301-1871

The provider's authorized official is Janice Holling .
The authorized official title is Center Director and has the following contact phone number (608) 301-9229.

The enumeration date for this NPI number is 2/5/2007 and was last updated on 10/21/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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