Cedar Pines, INC
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Wautoma, WI. Organization (NPI-2).
NPI number1144500331
StatusActive
Last updated in NPPESAug 19, 2011
Details
- NPI
- 1144500331
- Entity type
- Organization (NPI-2)
- Legal business name
- Cedar Pines, INC
- Organization subpart
- No
- Enumeration date
- Aug 19, 2011
- Last updated
- Aug 19, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | WI | Yes |
Practice location
101 W Division StWautoma, WI 54982-8467
Phone 920-229-3664
Mailing address
Po Box 506Sparta, WI 54656-0506
Phone 920-229-3664
Authorized official
Larenda L Rosin
President
9202293664
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