Organization
THE HUMAN SERVICE CENTER KOINONIA RESIDENTIAL TREATMENT CENTER
Active
Organization
THE HUMAN SERVICE CENTER KOINONIA RESIDENTIAL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK NORBERT BENNETT CLINICAL SUBSTANCE A (AODA ADMINISTRATOR)
(715) 362-5745
Entity
Organization
Contact information
Practice address
1991 WINNEBAGO STREET, RHINELANDER, WI 54501
(715) 362-5745
(715) 362-2819
Mailing address
PO BOX 1550, RHINELANDER, WI 54501
(715) 362-5745
(715) 362-2819
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/05/2007
Last updated
08/22/2020
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