Organization
WISCONSIN INDEPENDENT LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORINNA LUNDQUIST (PRESIDENT)
(920) 252-1054
Entity
Organization
Contact information
Practice address
757 PLEASANT LN, MENASHA, WI 54952-2439
(920) 215-3485
Mailing address
1610 W WISCONSIN AVE, APPLETON, WI 54914-3273
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
WI
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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