Rescare Residentail Services Wisconsin, LLC
NPI #1497271449 in Johnson Creek, Wisconsin
Provider Information
- NPI Number
- 1497271449
- Entity Type
- Organization
- Organization Name
- Rescare Residentail Services Wisconsin, LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Aug 21, 2017
- Last Updated
- Apr 10, 2024
Practice Location
- Address
- 540 VILLAGE WALK LN STE C
- City
- Johnson Creek
- State
- Wisconsin
- ZIP Code
- 53038-9554
- Phone
- (920) 261-3050
Authorized Official
- Name
- ANGIE MATTINGLY
- Title
- MGR PROVIDER ENROLLMENT
- Phone
- (502) 394-2100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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