OrganizationActive
Individual Growth Serivces, Inc.
NPI 1578935870 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Port Washington, WI
Provider details
- NPI number
- 1578935870
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Shawn Miles, Director(262) 284-9656
- License
- 390237 (WI)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 390237 (WI)
Residential Treatment Facilities
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1000 N Wisconsin St
Suite 5
Port Washington, WI 53074-1285
Phone: (262) 284-9656
Fax: (262) 284-4590
Street-level locationGet directions
Mailing address
1000 N Wisconsin St
Port Washington, WI 53074-1285
Registry dates
- Enumerated
- 2015-10-26
- Last updated
- 2015-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.