Organization
TCBY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DYANA HELT OT (PRESIDENT)
(414) 349-7564
Entity
Organization
Contact information
Practice address
528 VIOLET AVE, HARTFORD, WI 53027-1087
(414) 349-7564
(262) 673-0229
Mailing address
528 VIOLET AVE, HARTFORD, WI 53027-1087
(414) 349-7564
(262) 673-0229
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
257126
WI
320700000X
Physical Disabilities Residential Treatment Facility
257126
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134338882
—
WI
Enumeration date
05/19/2016
Last updated
05/19/2016
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