Organization
IRIS MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA SOTO (BILLING)
(414) 315-0429
Entity
Organization
Contact information
Practice address
2339 N 60TH ST, WAUWATOSA, WI 53210-2220
(414) 778-1222
(414) 778-1002
Mailing address
2339 N 60TH ST, WAUWATOSA, WI 53210-2220
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
WI
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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