Kelly Douglas
Kelly Douglas is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jefferson, Wisconsin. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
910 Hillside DrJefferson, WI 53549-1823
Phone: (920) 650-0027
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X |
|---|
Record details
| NPI number | 1093541831 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | September 9, 2024 |
| Last updated in NPPES | September 9, 2024 |
| Certification date | September 9, 2024 |
| Mailing address | 910 Hillside Dr, Jefferson, WI 53549-1823 |