PLATTEVILLE FAMILY RESOURCE CENTER (NPI# 1104207497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104207497 |
| Entity Type | Organization |
| Organization Name | PLATTEVILLE FAMILY RESOURCE CENTER |
| Other Organization Name | SW WI REGIONAL ELEM THERAPEUTIC CLASSROOM |
| Practice Address |
155 W Lewis St Platteville WI 53818-2103 |
| Mailing Address |
Po Box 36 Platteville WI 53818-0036 |
| Practice Telephone | 6086421563 |
| Practice Fax Number | 6083484191 |
| Mailing Telephone | 6083484060 |
| Mailing Fax Number | 6083484191 |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-08-04 |
| Authorized Official Name | DR. MARC WRUBLE (DIRECTOR) |
| Authorized Official Telephone | 6083484060 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | PLATTEVILLE FAMILY RESOURCE CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39757000 | 05 |
| Other Name | Type Code |
|---|---|
| SW WI Regional Elem Therapeutic Classroom | Doing Business As Name - Organization |
| Street Address |
155 W LEWIS ST |
| City | PLATTEVILLE |
| State | WI |
| Zip Code | 53818-2103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278329 | Shannon Millin | Nurse Practitioner | 1400 Eastside Road, Platteville, WI 53818 | 2019-01-08 |
| 1073014387 | Brittany Sarah Hirsch | Physical Therapy Assistant | 1886 W Timber Dr., Platteville, WI 53818 | 2018-02-22 |
| 1912419136 | Fasd Communitties Dba Aloha Community Platteville LLC | Social Worker | 7296 Bunker Ridge Rd, Platteville, WI 53818 | 2017-10-27 |
| 1053836262 | Richard Hodges | Counselor | 6058 S. Chestnut St., Suite 100, Platteville, WI 53818 | 2017-08-08 |
| 1609303031 | Joshua Eastlick | Counselor | 530 S Water St Ste 3, Platteville, WI 53818 | 2017-05-16 |
| 1417213778 | Charles Edward Paynter | Pharmacist | 1425 East Hwy 151, Platteville, WI 53818 | 2012-04-11 |
| 1164682753 | Tammy Lea Obe | Occupational Therapy Assistant | 1300 North Water Street, Platteville, WI 53818 | 2008-06-17 |
| 1629236211 | Angela Marie Meylor Omailia | Occupational Therapy Assistant | 1300 North Water St, Heartland Heath Care, Platteville, WI 53818 | 2008-05-30 |
| 1326214461 | Susan Kay Wallenhorst | Registered Nurse | 1510 Deborah Court, Platteville, WI 53818 | 2008-05-07 |
| 1962538397 | Richard J Neumeister | Dentist | M220 Mcgregor Plaza, Platteville, WI 53818 | 2007-02-27 |
| Find all providers in zip 53818 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953475 | County of Trempealeau | Community Based Residential Treatment Facility, Mental Illness | N36655 County Road Qqq, Whitehall, WI 54773-4401 | 2020-08-19 |
| 1932699873 | Dominique Lindsey | Community Based Residential Treatment Facility, Mental Illness | 4031 N 86th St, Milwaukee, WI 53222-1701 | 2018-05-16 |
| 1841706942 | Normic Enterprises Inc | Community Based Residential Treatment Facility, Mental Illness | N8761 Overland Dr, Watertown, WI 53094-9592 | 2017-12-27 |
| 1053858019 | Wise Management Inc. | Community Based Residential Treatment Facility, Mental Illness | 1538 W Liebau Rd, Mequon, WI 53092-2621 | 2017-01-27 |
| 1629513775 | Vessels of God | Community Based Residential Treatment Facility, Mental Illness | 2821 N 4th St # 304, Milwaukee, WI 53212-2362 | 2016-12-28 |
| 1871940213 | B.a.israel LLC | Community Based Residential Treatment Facility, Mental Illness | N9520 Silver Court, Appleton, WI 54915 | 2016-05-16 |
| 1902214182 | Mental Health Services, Inc | Community Based Residential Treatment Facility, Mental Illness | 1117 Clara Ave, Sheboygan, WI 53081-5317 | 2014-07-31 |
| 1346658234 | Phoenix Recovery Services LLC | Community Based Residential Treatment Facility, Mental Illness | 600 W Hickory St, Gilman, WI 54433-0188 | 2014-07-24 |
| 1801214457 | Mikolaj Szypicyn | Community Based Residential Treatment Facility, Mental Illness | 261 3rd St, Reedsburg, WI 53959-1621 | 2014-04-01 |
| 1598186991 | Campbell House LLC | Community Based Residential Treatment Facility, Mental Illness | 7197 Loper Rd, Sauk City, WI 53583-9552 | 2014-01-02 |
| Find all providers with the same taxonomy | ||||
| City | PLATTEVILLE |
| Zip Code | 53818 |
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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.