Organization
TEIPNER TREATMENT HOMES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA J CLARK MSW (DIRECTOR)
(920) 674-6688
Entity
Organization
Contact information
Practice address
104 W LINDEN DR STE A, JEFFERSON, WI 53549-2801
(920) 674-6688
(920) 674-6752
Mailing address
104 W LINDEN DR STE A, PO BOX 327, JEFFERSON, WI 53549-2801
(920) 674-6688
(920) 674-6752
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
285040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
285040
STATE OF WI FACILITY NUMBER
WI
Enumeration date
03/30/2009
Last updated
03/30/2009
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