NPI 1235266065

Northwest Passage LTD

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Frederic, WI

Practice location

Address: 203 United Way Drive, Frederic, WI 54837-8938
Phone: (715) 327-4402
Fax: (715) 327-4470

Authorised official

Name: Jackie J Maurer
Title: Business Office Supervisor
Phone: (715) 327-4322

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 560014 (WI)

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

Registry record

NPI: 1235266065
Entity type: Organization
NPI issued: 28 Feb 2007
Record last updated: 27 Mar 2012

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.