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Organization

STATE OF WISCONSIN

Active
Other names
Winnebago Mental Health Institute
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT G KNEEPKENS (DIRECTOR)
(920) 235-4910
Entity
Organization

Contact information

Practice address
1300 SOUTH DRIVE, WINNEBAGO, WI 54985-0009
(920) 235-4910
(920) 237-2043
Mailing address
1300 SOUTH DRIVE, WINNEBAGO, WI 54985-0009
(920) 235-4910
(920) 237-2043

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
250
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10063000
WI
Enumeration date
10/02/2006
Last updated
02/15/2008
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