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Alicia'S Place

Clinic/Center, Adult Day Care in Crandon, WI. Organization (NPI-2).

NPI number1669260808
StatusActive
Last updated in NPPESApr 28, 2025

Details

NPI
1669260808
Entity type
Organization (NPI-2)
Legal business name
Alicia'S Place
Organization subpart
No
Enumeration date
Apr 28, 2025
Certification date
Apr 28, 2025
Last updated
Apr 28, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QA0600X Clinic/Center, Adult Day Care––Yes
251J00000X Nursing Care––
385H00000X Respite Care––

Practice location

605 S Forest Ave
Crandon, WI 54520-1703

Phone 715-902-0848 · Fax 262-661-2206

Mailing address

501 E Grant St
Crandon, WI 54520-1673

Phone 715-902-0848 · Fax 262-661-2206

Authorized official

Kayla Charlene Van Cleve
Owner
7159020848

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