Mystic Creek, Llc

LBN: Mystic Creek, Llc
Mystic Creek, Llc is an health care organization with primary practice located at 12489 State Highway 56 , Viola WI 54664-8914. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Mystic Creek, Llc can be contacted via phone (608) 538-3781, or through Cook, Diane via phone (608) 538-3781.

Contact Information

Primary practice address
12489 State Highway 56 Viola WI 54664-8914
Phone: (608) 538-3781
Fax: (608) 538-3782
Website:
Map and Directions
Authorized official contact:
Name: Cook, Diane
Phone: (608) 538-3781

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X

Profile Details

NPI number 1356700025
LBN Legal business name Mystic Creek, Llc
DBA Doing business as
Authorized official Cook, Diane
Entity Organization
Organization subpart 1 No
Enumeration date Feb 23rd, 2016
Last updated Feb 23rd, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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