Organization
RAWHIDE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN LOUX (PRESIDENT AND CEO)
(920) 531-2500
Entity
Organization
Contact information
Practice address
E7475 RAWHIDE RD, NEW LONDON, WI 54961-9025
(920) 982-6100
Mailing address
E7475 RAWHIDE RD, NEW LONDON, WI 54961-9025
(920) 982-6100
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XM0800X
Mental Health Occupational Therapist
—
—
251S00000X
Community/Behavioral Health Agency
2750
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100089129
—
WI
05
—
42251600
—
WI
Enumeration date
02/16/2007
Last updated
05/31/2022
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