NPI 1578935870

Individual Growth Serivces, INC.

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Port Washington, WI

Practice location

Address: 1000 N Wisconsin St Suite 5, Port Washington, WI 53074-1285
Phone: (262) 284-9656
Fax: (262) 284-4590

Authorised official

Name: Shawn Patrick Miles
Title: Director
Phone: (262) 284-9656

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 390237 (WI)

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Registry record

NPI: 1578935870
Entity type: Organization
NPI issued: 26 Oct 2015
Record last updated: 26 Oct 2015

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.

Contact

(262) 284-9656 Open in maps

This is the number in the registry. Confirm before relying on it - practices move.

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