Mystic Creek, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MYSTIC CREEK, LLC

Practice address

12489 State Highway 56
Viola, WI 54664-8914

Phone

(608) 538-3781

Fax

(608) 538-3782

NPI assigned

Feb 23, 2016

Last updated

Jan 22, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane CookNPI 1093174765

Title

Owner

Phone

(608) 538-3781

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane Cook

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Viola, WI
  • NPI 1093174765

  Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1356700025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17969 WILSON SPRINGS RD",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535818588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12489 STATE HIGHWAY 56",
            "city": "VIOLA",
            "state": "WI",
            "postal_code": "546648914",
            "telephone_number": "608-538-3781",
            "fax_number": "608-538-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC CREEK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-538-3781"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Karn Helgerson
• Kickapoo Area School District
• Kickapoo Valley Rescue Squad Inc
• Sylvia Christine Longacre, ACUPUNCTURIST
• Mystic Acres, LLC
• Scenic Bluffs Health Center, Inc (Scenic Bluffs Community Health Centers)
• Viola Health Services and Osteoporosis Center, LTD

• Assisted Living Facility in Viola, WI
• Providers in Viola, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.