Organization
NORRIS ADOLESCENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD STEWART HARRIS MSW (EXECUTIVE DIRECTOR)
12626625900
Entity
Organization
Contact information
Practice address
W247S10395 CENTER DR, MUKWONAGO, WI 53149-9166
(262) 662-5900
(262) 662-5688
Mailing address
W247S10395 CENTER DR, MUKWONAGO, WI 53149-9166
(262) 662-5900
(262) 662-5688
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
265004
WI
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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