ST. COLETTA OF WISCONSIN, INC. (NPI# 1295113587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295113587 |
| Entity Type | Organization |
| Organization Name | ST. COLETTA OF WISCONSIN, INC. |
| Practice Address |
N4637 County Road Y Jefferson WI 53549-9720 |
| Practice Telephone | 9206744330 |
| Practice Fax Number | 9206748422 |
| Mailing Telephone | 9206744330 |
| Mailing Fax Number | 9206748422 |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2016-09-29 |
| Authorized Official Name | MR. TED BEHNCKE (PRESIDENT) |
| Authorized Official Telephone | 9206744330 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 251C00000X | Day Training, Developmentally Disabled Services | PROVISIONAL CERT | IL | Agencies |
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 199800003C | IL | Residential Treatment Facilities |
| Street Address |
N4637 COUNTY ROAD Y |
| City | JEFFERSON |
| State | WI |
| Zip Code | 53549-9720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740804913 | Anna E Warzala | Licensed Practical Nurse | Sunset Ridge Jefferson, 826 E. Reinel Street, Jefferson, Wi 53549, Jefferson, WI 53549 | 2020-06-03 |
| 1023428083 | Mary Beth Breunig | Occupational Therapist | 206 South Taft Avenue, Jefferson, WI 53549 | 2014-04-30 |
| 1841639952 | Debra Lee Schoenike | Licensed Practical Nurse | 610 S Main Street, Jefferson, WI 53549 | 2013-06-21 |
| 1073762191 | Katherine Sue Drechsler | Counselor | 1541 Annex Road, Jefferson, WI 53549 | 2008-09-12 |
| 1497960645 | Family Resources Associates Inc | Counselor | 248 S Wisconsin Drive, Jefferson, WI 53549 | 2007-05-11 |
| 1386707529 | Todd G Goldbeck | Physical Therapist | 1515 Highway 26 South, Jefferson, WI 53549 | 2006-12-19 |
| 1982780813 | Sport & Spine Clinic of Fort Atkinson Limited Partnership | Physical Therapist | 222 S Wisconsin Drive, Suite 3, Jefferson, WI 53549 | 2006-10-31 |
| 1033202528 | Marie Ann Maxwell-jones | Occupational Therapist | N3995 Annex Road, Jefferson, WI 53549 | 2006-10-02 |
| 1447216551 | Diane Mary Voelker | Registered Nurse | 224 Connelly D R, Jefferson, WI 53549 | 2006-04-26 |
| 1063477065 | Cynthia Lynn Miller | Registered Nurse | W4949 Streim Lane, Jefferson, WI 53549 | 2006-04-20 |
| Find all providers in zip 53549 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023558012 | Tiffany Norton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 518 N Clary Rd, Jefferson, ME 04348-4067 | 2017-02-24 |
| 1841431210 | The Magnolia School, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Central Ave, Jefferson, LA 70121-3402 | 2009-03-16 |
| 1770759532 | The Magnolia School, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Central Ave, Jefferson, LA 70121-3402 | 2008-05-01 |
| 1295911360 | The Magnolia School, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Central Ave, Jefferson, LA 70121-3402 | 2008-01-18 |
| 1104002278 | The Magnolia School, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Central Ave, Jefferson, LA 70121-3402 | 2008-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811597933 | Mount Pleasant Homes LLP | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1917 Mount Pleasant St, Racine, WI 53404-2236 | 2020-10-28 |
| 1730736927 | Horizon Life Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 217 Wisconsin Ave Ste 201, Waukesha, WI 53186-4946 | 2019-08-22 |
| 1316457203 | James Cares LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2422 Marshall Sq, Kansasville, WI 53139-9763 | 2017-10-05 |
| 1497271449 | Rescare Residentail Services Wisconsin, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 511 S Pelham St, Rhinelander, WI 54501-3316 | 2017-08-21 |
| 1144756685 | Safe Haven Senior Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 414 E 19th St, Marshfield, WI 54449-5074 | 2017-05-03 |
| 1407209109 | Shepherds Baptist Ministries Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1805 15th Ave, Union Grove, WI 53182-1527 | 2016-07-18 |
| 1790140382 | Iris Manor | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2339 N 60th St, Wauwatosa, WI 53210-2220 | 2015-12-23 |
| 1316312218 | A Place for Miracles Living Center LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7022 N 43rd St, Milwaukee, WI 53209-2219 | 2015-12-03 |
| 1396088639 | Bell Therapy, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 628 S 68th St, Milwaukee, WI 53214-1608 | 2013-04-05 |
| 1790039519 | Harbor Hope Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1626 S Park Ave, 908 Baldwin St, Neenah, WI 54956-5025 | 2012-10-31 |
| 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.