Organization
LORI KNAPP FOND DU LAC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD B KNAPP (CEO)
(608) 326-5536
Entity
Organization
Contact information
Practice address
625 FOND DU LAC AVE, FOND DU LAC, WI 54935
(920) 907-0949
(920) 907-0961
Mailing address
625 FOND DU LAC AVE, FOND DU LAC, WI 54935
(920) 907-0949
(920) 907-0961
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/05/2008
Last updated
09/05/2008
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