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Organization
STATE OF WISCONSIN
Active
Organization
STATE OF WISCONSIN
Active
Parent organization
STATE OF WISCONSIN
Other names
Central Wisconsin Center Pharmacy Department
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF WISCONSIN
Authorized official
MRS. JANICE HOLLING (CENTER DIRECTOR)
(608) 301-9229
Entity
Organization
Contact information
Practice address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-1946
(608) 301-1871
Mailing address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-1946
(608) 301-1871
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
1000-042
WI
Other
Enumeration date
02/05/2007
Last updated
10/21/2010
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