MEDICARE: REFUGE FARMS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1184972853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFUGE FARMS, INC.

Provider Business Mailing Address
First Line	:	3035 STATE ROAD 29
Second Line	:
City	:	SPRING VALLEY
State	:	WI
Zip	:	54767-8290
Country	:	US
Telephone Number	:	715-772-3379
Fax Number	:	715-772-3379

Provider Business Practice Location Address
First Line	:	3035 STATE ROAD 29
Second Line	:
City	:	SPRING VALLEY
State	:	WI
Zip	:	54767-8290
Country	:	US
Telephone Number	:	715-772-3379
Fax Number	:	715-772-3379

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR, PRESIDENT
Name	:	MS. SANDRA LEE GILBERT
Credential	:
Telephone Number	:	715-772-3328

Provider Enumeration Date	:	08/28/2012
Last Update Date	:	03/12/2013

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Directions to “REFUGE FARMS, INC. ” Practice Location

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