NPI 1093541831

Kelly Douglas

Practitioner Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Jefferson, WI

Practice location

Address: 910 Hillside Dr, Jefferson, WI 53549-1823
Phone: (920) 650-0027

Registered specialties

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

Residential Treatment Facilities Taxonomy 320900000X

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

Registry record

NPI: 1093541831
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Sep 2024
Record last updated: 9 Sep 2024

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.