IndividualActive
Tawana Lyons
NPI 1558068874 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Racine, WI
Provider details
- NPI number
- 1558068874
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 0018876 (WI)
Mailing address
2332 Gilson St
Racine, WI 53403-3010
Registry dates
- Enumerated
- 2023-02-08
- Last updated
- 2023-02-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.