Organization
THE HEALING HAVEN OF WISCONSIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA R WENGER (FOUNDER/OWNER)
(414) 333-4128
Entity
Organization
Contact information
Practice address
W244N4850 SWAN RD, PEWAUKEE, WI 53072-1402
(414) 333-4128
Mailing address
W244N4850 SWAN RD, PEWAUKEE, WI 53072-1402
(414) 333-4128
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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