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Organization

STATE OF WISCONSIN

Active
Parent organization
CENTRAL WISCONSIN CENTER
Other names
Rehabiliation Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRAL WISCONSIN CENTER
Authorized official
KIMBERLY A COPLIEN PT, DPT (DIRECTOR OF REHABILITATION SERVICES)
(608) 301-9382
Entity
Organization

Contact information

Practice address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-9382
Mailing address
317 KNUTSON DR, MADISON, WI 53704-1133

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41225300
WI
Enumeration date
01/02/2008
Last updated
01/26/2016
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