Organization
HIDDEN PINES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARENDA ROSIN (PRESIDENT)
(608) 487-9067
Entity
Organization
Contact information
Practice address
N5085 18TH RD, WILD ROSE, WI 54984-5915
(920) 622-3711
(920) 622-3711
Mailing address
8429 IDYLLVIEW AVE, SPARTA, WI 54656-3617
(608) 487-9067
(608) 487-9067
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/03/2009
Last updated
12/03/2009
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