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General NPI Number Information
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NPI Number | 1255288502
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Entity Type | Individual
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Provider Name | MRS. AMBER HACKL
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Gender | Female
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 8519 STEELE ST
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City | BURLINGTON
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State | WI
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Zip | 53105-9266
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Country | US
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Telephone | 262-758-8756
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Fax |
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Provider Business Mailing Address
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Address Line | 33427 BOHNER DR
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City | BURLINGTON
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State | WI
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Zip | 53105-8348
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Country | US
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Telephone | 262-758-8756
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 0021428
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License Number State | WI
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