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Organization
STATE OF WISCONSIN
Active
Organization
STATE OF WISCONSIN
Active
Parent organization
CENTRAL WISCONSIN CENTER
Other names
Rehabiliation Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL WISCONSIN CENTER
Authorized official
KIMBERLY A COPLIEN PT, DPT (DIRECTOR OF REHABILITATION SERVICES)
(608) 301-9382
Entity
Organization
Contact information
Practice address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-9382
Mailing address
317 KNUTSON DR, MADISON, WI 53704-1133
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41225300
—
WI
Enumeration date
01/02/2008
Last updated
01/26/2016
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