Individual Growth Serivces, Inc.
NPI #1578935870 in Port Washington, Wisconsin
Provider Information
- NPI Number
- 1578935870
- Entity Type
- Organization
- Organization Name
- Individual Growth Serivces, Inc.
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Oct 26, 2015
- Last Updated
- Oct 26, 2015
Practice Location
- Address
- 1000 N WISCONSIN ST
- Address 2
- SUITE 5
- City
- Port Washington
- State
- Wisconsin
- ZIP Code
- 53074-1285
- Phone
- (262) 284-9656
Authorized Official
- Name
- SHAWN PATRICK MILES
- Title
- DIRECTOR
- Phone
- (262) 284-9656
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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