Organization
EXODUS TRANSITIONAL CARE FACILITY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL E COLWIN (CLINICAL SUPERVISOR/DIRECTOR)
(262) 626-4166
Entity
Organization
Contact information
Practice address
1421 FOND DU LAC AVE, KEWASKUM, WI 53040-9136
(626) 626-4166
(262) 626-8431
Mailing address
1421 FOND DU LAC AVE, KEWASKUM, WI 53040-9136
(262) 626-4166
(262) 626-8431
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
2598
WI
Other
Enumeration date
03/26/2014
Last updated
03/12/2021
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