Provider Demographics
NPI:1134366230
Name:ARBOR LIVING LLC
Entity type:Organization
Organization Name:ARBOR LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GEDNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-305-4556
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:WALES
Mailing Address - State:WI
Mailing Address - Zip Code:53183-0407
Mailing Address - Country:US
Mailing Address - Phone:262-305-4556
Mailing Address - Fax:262-392-3556
Practice Address - Street 1:S28W30753 WILD BERRY LN
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-9106
Practice Address - Country:US
Practice Address - Phone:262-305-4556
Practice Address - Fax:262-392-3556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities