NPI 1114196854

Lad Lake, INC.

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Dousman, WI

Practice location

Address: W350s1401 Waterville Rd, Dousman, WI 53118-9020
Phone: (262) 965-2131

Authorised official

Name: Gary L Erdmann
Title: Executive Director
Phone: (262) 965-2131

Registered specialties (2)

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 265001 (WI)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Wisconsin →

Mental Illness Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320800000X Licence NONE (WI)

Other Community Based Residential Treatment Facility, Mental Illness providers in Wisconsin →

Registry record

NPI: 1114196854
Entity type: Organization
NPI issued: 27 Feb 2008
Record last updated: 27 Feb 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.