Organization
BERLIN PINES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERI M HAYWOOD (OWNER)
(920) 229-3664
Entity
Organization
Contact information
Practice address
642 BROADWAY, BERLIN, WI 54923-1302
(920) 290-3090
(920) 290-3090
Mailing address
PO BOX 506, SPARTA, WI 54656-0506
(920) 229-3664
(608) 487-9067
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
0014624
WI
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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