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Organization

ST. COLETTA OF WISCONSIN, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT ARTHUR SCHMIDT MBA (DIRECTOR OF DAY PROGRAMS & SERVICES)
(920) 674-8219
Entity
Organization

Contact information

Practice address
N4637 COUNTY ROAD Y, JEFFERSON, WI 53549-9720
(920) 674-4330
(920) 674-8422
Mailing address
N4637 COUNTY ROAD Y, JEFFERSON, WI 53549-9720
(920) 674-4330
(920) 674-8422

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
PROVISIONAL CERTIFIC
IL
251E00000X
Home Health Agency
261QA0600X
Adult Day Care Clinic/Center
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
199800003C
IL

Other

Enumeration date
05/07/2015
Last updated
10/08/2024
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