Organization
ALICIA'S PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAYLA CHARLENE VAN CLEVE RN (OWNER)
(715) 902-0848
Entity
Organization
Contact information
Practice address
605 S FOREST AVE, CRANDON, WI 54520-1703
(715) 902-0848
(262) 661-2206
Mailing address
501 E GRANT ST, CRANDON, WI 54520-1673
(715) 902-0848
(262) 661-2206
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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