Pine Valley Residential Services
Community Based Residential Treatment Facility, Mental Illness in Mauston, WI. Organization (NPI-2).
Details
- NPI
- 1891126751
- Entity type
- Organization (NPI-2)
- Legal business name
- Pine Valley Residential Services
- Organization subpart
- No
- Enumeration date
- Dec 3, 2013
- Certification date
- Aug 28, 2023
- Last updated
- Aug 28, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | AFH | WI | Yes |
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | AFH | WI | |
| 251B00000X | Case Management | 7163-123 | WI | |
| 251S00000X | Community/Behavioral Health | 7163-123 | WI |
Other names
- Pine Valley Services (Other Name)
Practice location
124 Grayside AveMauston, WI 53948-1913
Phone 608-847-7575 · Fax 608-847-3096
Mailing address
Po Box 359Mauston, WI 53948-0359
Phone 608-847-7575 · Fax 608-847-3096
Other practice locations
Lyndon Station, WI 53944-9398
Phone 608-847-7575 · Fax 608-847-3096
Authorized official
Jessica Schulz
Ceo / Owner Member LLC
6088477575
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 10 free a day, then credits from $29 for 5,000. Useful for credentialing, billing and pharmacy claim checks.