Organization
LIFEKEEPERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS AUGUSTINE (PRESIDENT AND CEO)
(608) 697-5987
Entity
Organization
Contact information
Practice address
N6706 OLD RIVER RD, PORTAGE, WI 53901-9522
(608) 742-2788
Mailing address
515 WASHINGTON ST STE A, PORTAGE, WI 53901-2442
(608) 745-9004
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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