NPI 1184861635

Team Discoery

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

Practice location

Address: 2178 N 74th St, Wauwatosa, WI 53213-1702
Phone: (414) 467-2255
Fax: (262) 252-4214
Mailing address: W130n6650 Northfield Dr, Menomonee Falls, WI 53051-0515

Authorised official

Name: Laurence Trimble
Title: Administrator
Phone: (414) 467-2255

Registered specialties (2)

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 12606 (WI)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Wisconsin →

Intellectual and/or Developmental Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320600000X Licence 12617 (WI)

Registry record

NPI: 1184861635
Entity type: Organization
NPI issued: 20 Jan 2009
Record last updated: 20 Jan 2009

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.