NPI 1164301461

Farah a Iimie

Practitioner Intellectual and/or Developmental Disabilities Residential Treatment Facility Plover, WI

Practice location

Address: 3331 Bridlewood Dr, Plover, WI 54467-3867
Phone: (920) 714-6988

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 9239202500 (WI)

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

Registry record

NPI: 1164301461
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Aug 2025
Record last updated: 29 Aug 2025

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.