Mystic Creek, Llc, NPI 1356700025
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Viola, WI, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1356700025
NPI Entity Type Organization
Provider Name Mystic Creek, Llc
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 12489 State Highway 56, Viola, WI, US
Provider Mailing Address 17969 Wilson Springs Rd, Richland Center, WI, US, 535818588
Is Sole Proprietor? No
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Organization Official

Official Name Diane Cook
Official Position OWNER
Phone 608-538-3781

Primary Taxonomy

Taxonomy Code

320600000X

Taxonomy Name Intellectual and/or Developmental Disabilities Residential Treatment Facility
Classification

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Group

Residential Treatment Facilities

Description A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Business Address

Mystic Creek, Llc
12489 State Highway 56

Viola, WI, US

Phone: 608-538-3781
Fax: 608-538-3782

Mailing Address

Mystic Creek, Llc
17969 Wilson Springs Rd
Richland Center, WI, US
ZIP 535818588

Other Providers in WI, US

NPI Name Taxonomy Address

1205582921

Timothy H Mcdonough

Individual

Medical Physician Assistant

600 Highland Ave

Madison, WI

1265832497

PA-C Jennifer Parnell

Individual

Physician Assistant

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Oshkosh, WI

1578570974

Dean Health Systems, Inc

Organization

Comprehensive Outpatient Rehabilitation Facility (CORF)

1821 S Stoughton Rd

Madison, WI

1306426044

DDS Katherine Anne Knabe

Individual

General Practice Dentistry

5337 W Grande Market Dr

Appleton, WI

1811612187

PA(ASCP) Amanda Katsma

Individual

Pathology Technician

5000 W National Ave

Milwaukee, WI

1669109641

MRS. APNP, PMHNP-BC Tilly Burroughs

Individual

Psychiatric/Mental Health Nurse Practitioner

1114 56th St

Kenosha, WI

1881319242

Shong Chang

Individual

Physical Therapy Assistant

10 Tower Dr

Sun Prairie, WI

1578288924

Golden Medical Transportation Llc

Organization

Non-emergency Medical Transport (VAN)

1740 E Mason St # 5

Green Bay, WI

1043862386

LCSW, SAC-IT Alexandra Duvall

Individual

Clinical Social Worker

540 College St

Medford, WI

1073238424

D-PT Rachel Ann Lohrengel

Individual

Physical Therapist

744 S Webster Ave

Green Bay, WI

1225531353

LPC Rebecca A Richards

Individual

Professional Counselor

820 Washington St

Manitowoc, WI

1932468576

DR. D.O. Meredith Caroline Schaffner

Individual

Medical Oncology Physician

1836 South Ave

La Crosse, WI

1396460739

Rebecca Fafard

Individual

Case Manager/Care Coordinator

702 W Main St

Madison, WI

1811916281

Fort Healthcare, Inc.

Organization

General Acute Care Hospital

611 Sherman Ave E

Fort Atkinson, WI

1447304340

Fort Healthcare, Inc.

Organization

Skilled Nursing Facility

611 Sherman Ave E

Fort Atkinson, WI

1417993361

Fort Healthcare Inc

Organization

Counselor

611 Sherman Ave E

Fort Atkinson, WI

1669843223

MRS. LPC Holly L Doughty

Individual

Professional Counselor

120 E 4th St

Kaukauna, WI

1376680330

Fort Memorial Hospital

Organization

Non-Pharmacy Dispensing Site

611 Sherman Ave E

Fort Atkinson, WI

1417450115

Fort Healthcare Inc

Organization

Rural Health Clinic/Center

500 Mcmillen St

Fort Atkinson, WI

1063566966

Fort Healthcare, Inc

Organization

Home Health Agency

611 Sherman Ave E

Fort Atkinson, WI

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