Organization
WILLOWGLEN ACADEMY-WISCONSIN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA SANDEE (DIRECTOR RESIDENTIAL SERVICES)
(414) 527-6970
Entity
Organization
Contact information
Practice address
1111 REED ST, PLYMOUTH, WI 53073-2506
(920) 565-6004
Mailing address
1111 REED ST, PLYMOUTH, WI 53073-2506
(920) 565-6004
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1001570
WI
Other
Enumeration date
07/03/2007
Last updated
06/25/2008
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