THUNDERMIST, INC.


Address: 2108a Silvernail Rd, Suite 116, Pewaukee, WI 53072-5526
Phone: 8884689981

THUNDERMIST, INC. (NPI# 1003179953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003179953
Entity Type Organization
Organization Name THUNDERMIST, INC.
Practice Address 2108a Silvernail Rd
Suite 116
Pewaukee
WI 53072-5526
Practice Telephone 8884689981
Mailing Telephone 8884689981
Enumeration Date 2012-06-15
Last Update Date 2012-06-15
Authorized Official Name SEAN B JONES (CEO/PRESIDENT)
Authorized Official Telephone 8888984591
Authorized Official Credential LLC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM0850X Clinic/Center
Specialization: Adult Mental Health
Ambulatory Health Care Facilities
Y 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
Ambulatory Health Care Facilities

Office Location

Street Address 2108A SILVERNAIL RD
SUITE 116
City PEWAUKEE
State WI
Zip Code 53072-5526

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Taxonomy Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Notes: [7/1/2003: new]

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Competitor

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City PEWAUKEE
Zip Code 53072

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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