NPI 1144500331

Cedar Pines, INC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Wautoma, WI

Practice location

Address: 101 W Division St, Wautoma, WI 54982-8467
Phone: (920) 229-3664
Mailing address: PO Box 506, Sparta, WI 54656-0506

Authorised official

Name: Larenda L Rosin
Title: President
Phone: (920) 229-3664

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1144500331
Entity type: Organization
NPI issued: 19 Aug 2011
Record last updated: 19 Aug 2011

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.