Provider Demographics
NPI:1073647665
Name:ARBOR PLACE, INC.
Entity Type:Organization
Organization Name:ARBOR PLACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUINARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-235-4537
Mailing Address - Street 1:4076 KOTHLOW AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-3090
Mailing Address - Country:US
Mailing Address - Phone:715-235-4537
Mailing Address - Fax:715-235-4535
Practice Address - Street 1:4076 KOTHLOW AVE
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-3090
Practice Address - Country:US
Practice Address - Phone:715-235-4537
Practice Address - Fax:715-235-4535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1050324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility