Berlin Pines, Inc

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Berlin, WI

NPI 1679913487 · NPPES record last updated Jun 26, 2013

Key facts

NPI
1679913487
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
License
0014624 (WI)
Legal business name
BERLIN PINES, INC
Practice address
642 Broadway
Berlin, WI 54923-1302
Phone
(920) 290-3090
Fax
(920) 290-3090
NPI assigned
Jun 26, 2013
Organization subpart
No

Authorized official

Name
Keri M Haywood
Title
Owner
Phone
(920) 229-3664

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 0014624 WI Yes

Addresses

Primary practice location

642 Broadway
Berlin, WI 54923-1302

Mailing address

PO Box 506
Sparta, WI 54656-0506
Phone (920) 229-3664

Other providers in Berlin, WI

All providers in Berlin, WI · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Wisconsin

Sources for this page

Verify at the official NPI Registry.