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Organization

WISCONSIN RECOVERY INSTITUTE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACOB EDELSTEIN (OWNER)
(949) 245-8625
Entity
Organization

Contact information

Practice address
1446 LYNN AVE, FOND DU LAC, WI 54937-6900
(920) 990-2104
Mailing address
1446 LYNN AVE, FOND DU LAC, WI 54937-6900
(920) 990-2104

Taxonomy

Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
323P00000X
Psychiatric Residential Treatment Facility
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
04/23/2024
Last updated
04/23/2024
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