Organization
STATE OF WISCONSIN
Active
Other names
Central Wisconsin Center for the Developmentally Disabled
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTON O SCHALICK III MD,PHD (MEDICAL DIRECTOR)
(609) 301-9231
Entity
Organization
Contact information
Practice address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-9200
(608) 301-1811
Mailing address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-9200
(608) 301-1811
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2780
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21050100
—
WI
Enumeration date
12/12/2006
Last updated
12/10/2024
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