Lad Lake, Inc. in Dousman - Community Based Residential Treatment Facility, Mental Illness
Lad Lake, Inc. - NPI 1114196854
Lad Lake, Inc. is a Community Based Residential Treatment Facility, Mental Illness in Dousman, Wisconsin. Lad Lake, Inc. practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Lad Lake, Inc. is 1114196854. The last update date is 2008-02-27.
Lad Lake, Inc.'s current location address is W350s1401 Waterville Rd, Dousman, Wisconsin. You can contact this provider via phone number 2629652131. The mailing address for Lad Lake, Inc. is W350s1401 Waterville Rd, Dousman, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lad Lake, Inc. |
|---|---|
| Address | W350s1401 Waterville Rd, Dousman, Wisconsin |
| Phone Number | 2629652131 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Erdmann L Gary |
| Telephone Number | 2629652131 |
NPI Number Detail
| NPI Number | 1114196854 |
|---|---|
| Provider Enumeration Date | 2008-02-27 |
| Last Updated Date | 2008-02-27 |
Provider Mailing Address Detail
| Address | W350s1401 Waterville Rd |
|---|---|
| City | Dousman |
| State | Wisconsin (WI) |
| Post Code | 531189020 |
| Phone Number | 2629652131 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
| Licence No | NONE |
|
Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
|
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Lad Lake, Inc. by the Centers for Medicare & Medicaid Services?
The Lad Lake, Inc. has been issued the NPI (National Provider Identifier) 1114196854 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Lad Lake, Inc. is located?
The Lad Lake, Inc. is situated at the following address: W350S1401 Waterville Rd, Dousman, WI, 531189020.
What is Lad Lake, Inc.'s area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Lad Lake, Inc. is Community Based Residential Treatment Facility, Mental Illness, and the taxonomy code that categorizes this field of expertise is 320800000X.
When did Lad Lake, Inc. receive its 1114196854 assignment?
The Lad Lake, Inc. was assigned its 1114196854 on 2008-02-27, which is the date when this unique identifier was issued to the organization.
As of what date were the Lad Lake, Inc.'s details last updated?
The information pertaining to the Lad Lake, Inc., including its address, specialty, and other details, was most recently updated on 2008-02-27.
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