National Provider Identifier Database

WISCONSIN RECOVERY INSTITUTE
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

WISCONSIN RECOVERY INSTITUTE
1446 LYNN AVE
FOND DU LAC, WI54937-6900
Phone: 920-990-2104
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X
Psychiatric Residential Treatment Facility 323P00000X
Rehabilitation, Substance Use Disorder Unit 276400000X

* Indicates primary specialty

NPI Profile & details for WISCONSIN RECOVERY INSTITUTE

NPI Number 1053166942
Legal business name
LBN
WISCONSIN RECOVERY INSTITUTE
Authorized official JACOB EDELSTEIN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 04/23/2024
Last updated 04/23/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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