Provider Demographics
NPI:1558798686
Name:FRIENDS OF WOMEN IN RECOVERY, INC.
Entity Type:Organization
Organization Name:FRIENDS OF WOMEN IN RECOVERY, INC.
Other - Org Name:BEACON HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-923-3999
Mailing Address - Street 1:PO BOX 1524
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54936-1524
Mailing Address - Country:US
Mailing Address - Phone:920-923-3999
Mailing Address - Fax:920-923-3240
Practice Address - Street 1:166 S PARK AVE
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-4441
Practice Address - Country:US
Practice Address - Phone:920-923-3999
Practice Address - Fax:920-923-3240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility