Organization
ST. COLETTA OF WISCONSIN, INC.
Active
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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