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General NPI Number Information
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NPI Number | 1831012491
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Entity Type | Organization
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Legal Business Name | HOMES FOR ALTERNATIVE LIVING OF WISCONSIN LLC
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 813 FAIRMONT AVE
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City | MADISON
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State | WI
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Zip | 53714-1112
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Country | US
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Telephone | 202-888-9025
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Fax | 608-821-0824
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Provider Business Mailing Address
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Address Line | 813 FAIRMONT AVE
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City | MADISON
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State | WI
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Zip | 53714-1112
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Country | US
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Telephone | 202-888-9025
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Fax | 608-821-0824
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | N DANISH
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Credential | MSI
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Telephone | 202-888-9025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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