Organization
UNITED CARE HOMES OF WISCONSIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN AL HERMAN (ADMINISTRATOR)
(262) 719-2270
Entity
Organization
Contact information
Practice address
338 MUNICIPAL DR, WEST BEND, WI 53095-3510
(262) 719-2270
Mailing address
338 MUNICIPAL DR, WEST BEND, WI 53095-3510
(262) 719-2270
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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