Organization
CEDAR PINES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LARENDA L ROSIN (PRESIDENT)
(920) 229-3664
Entity
Organization
Contact information
Practice address
101 W DIVISION ST, WAUTOMA, WI 54982-8467
(920) 229-3664
Mailing address
PO BOX 506, SPARTA, WI 54656-0506
(920) 229-3664
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
WI
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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