DARJUNE FOUNDATION, INC. (NPI# 1114485562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114485562 |
| Entity Type | Organization |
| Organization Name | DARJUNE FOUNDATION, INC. |
| Practice Address |
130 N Maple Ave Green Bay WI 54303-2748 |
| Mailing Address |
2055 S Tanager Ln Suamico WI 54313-4003 |
| Practice Telephone | 9206769697 |
| Mailing Telephone | 9206769697 |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-03-05 |
| Authorized Official Name | AMANDA SUTHERS (CEO) |
| Authorized Official Telephone | 9206769697 |
| Authorized Official Credential | SAC-IT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 253J00000X | Foster Care Agency | Agencies | ||
| N | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
Respite Care Facility | ||
| Y | 405300000X | Prevention Professional | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1018 Shawano Ave, Green Bay, WI 543033021 | 9206769697 |
| Street Address |
130 N MAPLE AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-2748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326679663 | Andrea Maria Dosedla | Prevention Professional | N61w23044 Harrys Way, Sussex, WI 53089-3995 | 2020-01-27 |
| 1063981710 | Jon Maurice Smoots | Prevention Professional | 7710 W. Casper Street, Milwaukee, WI 53216 | 2018-11-23 |
| 1023527769 | Red Road House | Prevention Professional | 152 S Locust St, Janesville, WI 53548-3767 | 2017-09-26 |
| 1164963187 | Anna Lanman | Prevention Professional | 303 12th Ave, Baraboo, WI 53913-1612 | 2017-03-09 |
| 1407396013 | Douglas Radtke | Prevention Professional | 6233 Bankers Rd, Suite 12, Mount Pleasant, WI 53403-9700 | 2017-03-01 |
| 1659819076 | Haley Jacob | Prevention Professional | 1725 State St, 126 Mitchell Hall, La Crosse, WI 54601-3742 | 2017-02-06 |
| 1043627912 | Sonia Porter | Prevention Professional | 5151 W Silver Spring Dr, Milwaukee, WI 53218-3300 | 2014-07-12 |
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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.