Organization
WILLOWGLEN HEIN FOSTER CARE GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYA SINGH PH.D. (DIRECTOR RESIDENTIAL SERVICES)
(414) 527-6970
Entity
Organization
Contact information
Practice address
207 HEIN AVE, PLYMOUTH, WI 53073-2526
(920) 893-5132
Mailing address
207 HEIN AVE, PLYMOUTH, WI 53073-2526
(920) 893-5132
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1005423
WI
Other
Enumeration date
07/03/2007
Last updated
08/22/2020
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