SUNDANCE REHABILITATION LLC (NPI# 1073912119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073912119 |
| Entity Type | Organization |
| Organization Name | SUNDANCE REHABILITATION LLC |
| Practice Address |
6902 Parkside Cir Deforest WI 53532-2560 |
| Mailing Address |
101 E State St Kennett Square PA 19348-3109 |
| Practice Telephone | 6109254560 |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DANIEL A HIRSCHFELD (PRESIDENT) |
| Authorized Official Telephone | 6109254025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 597 Kingswood Ave, Fond Du Lac, WI 549356399 | 9202383032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750336053 | Sundance Rehabilitation LLC | Clinic/Center | 102b Kings Way W, Sewell, NJ 08080-2235 | 2006-05-24 |
| 1841245701 | Sundance Rehabilitation LLC | Clinic/Center | 3933 S Prairie Hill Ln, C/o Hickory Park, Greenfield, WI 53228-2371 | 2006-05-22 |
| Street Address |
6902 PARKSIDE CIR |
| City | DEFOREST |
| State | WI |
| Zip Code | 53532-2560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720459597 | Nicole Bruecker | Physical Therapy Assistant | 6902 Parkside Cir, Deforest, WI 53532-2560 | 2015-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952650541 | Laura B Cole | Licensed Practical Nurse | 405 Anderson St., Deforest, WI 53532 | 2012-08-29 |
| 1043429707 | Tracy Beth Head | Pharmacist | 643 S. Main Street, Deforest, WI 53532 | 2007-05-21 |
| 1588702237 | Patricia Herschleb | Pharmacist | W6850 County Road Dm, De Forest, WI 53532 | 2007-02-02 |
| 1821147661 | Kathryn Marie Cacic | Nurse Practitioner | 7752 Clinton Road, Deforest, WI 53532 | 2007-01-10 |
| 1306915079 | Bakke Chiropractic Clinic Sc | Chiropractor | Bakke Chiropractic Clinic Sc, 312 East North Street, Deforest, WI 53532 | 2006-11-07 |
| 1689772485 | Gregg Nelson Bakke | Chiropractor | 312 East North Street, Bakke Chiropractic Clinic Sc, Deforest, WI 53532 | 2006-09-20 |
| 1730282344 | Deforest Dental Services | Dentist | 210 N. Main St., Ste 103, Deforest, WI 53532 | 2006-09-07 |
| 1326038670 | Trixie Irene Eakin | Optometrist | 101 S. Main St, De Forest, WI 53532 | 2005-10-27 |
| 1245663988 | Group Health Cooperative of South Central Wisconsin Deforest Clinic | Durable Medical Equipment & Medical Supplies | 815 S Main St, Deforest, WI 53532 | 2013-08-16 |
| 1205953866 | Essential Family Vision Care, S.c. | Optometrist | 101 S. Main St, De Forest, WI 53532 | 2007-03-26 |
| Find all providers in zip 53532 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
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| 1508409293 | Boost Home Health LLC | Clinic/Center | 1198 121st Ave, New Richmond, WI 54017-7158 | 2019-10-24 |
| 1912481185 | Visiting Nurse Community Care, Inc. | Clinic/Center | 600 52nd St Ste 300, Kenosha, WI 53140-3423 | 2018-09-24 |
| 1790270932 | Genesis Eldercare Rehabilitation Services LLC | Clinic/Center | 533 E Calumet St, Chilton, WI 53014-1649 | 2018-06-29 |
| 1225548316 | Thrive Learning Center, LLP | Clinic/Center | N3219 County Road H Ste F, Lake Geneva, WI 53147-7074 | 2017-10-03 |
| 1720431877 | Milwaukee Center for Independence | Clinic/Center | 6100 N Baker Rd, Glendale, WI 53209-3704 | 2016-07-13 |
| 1518334986 | Physiotherapy Associates Inc | Clinic/Center | 3910 W Lisbon Ave, Milwaukee, WI 53208-1834 | 2015-09-01 |
| 1417367509 | Specialized Therapy Services LLC | Clinic/Center | 890 Elm Grove Rd Ste 1-1, Elm Grove, WI 53122-2528 | 2014-04-29 |
| 1710300173 | Genesis Eldercare Rehabilitation Services LLC | Clinic/Center | 1800 Bluebell Ln, C/o Harmony of Stevens Point, Stevens Point, WI 54482-8983 | 2014-01-21 |
| 1386900918 | Ministry Door County | Clinic/Center | 323 S 16th Pl, Sturgeon Bay, WI 54235 | 2012-04-09 |
| Find all providers with the same taxonomy | ||||
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| 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.