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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