Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sumac Residential LLC

Organization Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1912214966

Sumac Residential LLC is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Hudson, 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

723 B Blue Jay Ln
Hudson, WI 54016
Phone: (715) 255-0466
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) Taxonomy 320600000X (WI)

Record details

NPI number1912214966
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Rusk — Owner · (715) 255-0466
Other names Blue Jay Assisted Living
NPI enumeratedSeptember 10, 2010
Last updated in NPPESSeptember 10, 2010
Mailing address723b Blue Jay Ln, Hudson, WI 54016-7695

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