Individual
FARAH A IIMIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3331 BRIDLEWOOD DR, PLOVER, WI 54467-3867
(920) 714-6988
Mailing address
3331 BRIDLEWOOD DR, PLOVER, WI 54467-3867
(920) 714-6988
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
9239202500
WI
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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