Country Grove Home LLC

Organization Assisted Living Facility (Mental Illness) · NPI 1306162706

Country Grove Home LLC is an Assisted Living Facility (Mental Illness) in Necedah, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2010.

Licensed in: WI
In the registry since: 2010

What do these letters mean?

LLC — Limited liability company: A form of business registration, not a clinical qualification.

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Practice location Address checks out

N11151 17th Ave
Necedah, WI 54646-7619
Phone: (608) 565-2735

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (Mental Illness) (primary)	Taxonomy 3104A0625X · Licence 0011011 (WI)

Record details

NPI number	1306162706
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Scott Peak — Owner · (608) 547-2755
NPI enumerated	April 12, 2010
Last updated in NPPES	April 12, 2010
Mailing address	N10414 18th Ave, Necedah, WI 54646-7934