TELLURIAN, INC.


Address: 4647 Mormon Coulee Rd, La Crosse, WI 54601-8225
Phone: 6085193080

TELLURIAN, INC. (NPI# 1437401338) 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) 1437401338
Entity Type Organization
Organization Name TELLURIAN, INC.
Other Organization Name TELLURIAN UCAN, INC.
Practice Address 4647 Mormon Coulee Rd
La Crosse
WI 54601-8225
Practice Telephone 6085193080
Practice Fax Number 6085193083
Mailing Telephone 6085193080
Mailing Fax Number 6085193083
Enumeration Date 2012-10-03
Last Update Date 2019-05-06
Authorized Official Name KELLY E CROOKS (QUALITY ASSURANCE MANAGER)
Authorized Official Telephone 6086632120
Authorized Official Credential MSW
Is Organization Subpart Y
Parent Organization Name TELLURIAN, INC.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness 0013220 WI Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
La Crosse CARE Center Other Name - Individual/Organization
Tellurian UCAN, inc. Former Legal Business Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1043487697 Tellurian, Inc. Community/Behavioral Health 2914 Industrial Dr, Madison, WI 53713-4047 2008-05-13
1164432118 Tellurian, Inc. Psychiatry & Neurology 1053 Williamson St, Madison, WI 53703-3525 2006-08-09
1740213776 Tellurian, Inc. Community/Behavioral Health 300 Femrite Dr, Monona, WI 53716-3716 2006-07-10
1104279330 Tellurian, Inc. Community/Behavioral Health 414 Broadway St, Suite 101, Baraboo, WI 53913-2488 2016-07-22
1013261486 Tellurian, Inc. Substance Abuse Rehabilitation Facility 2914 Industrial Dr, Madison, WI 53713-4047 2012-11-06
1609129410 Tellurian, Inc. Community Based Residential Treatment Facility, Mental Illness 300 Femrite Dr, Monona, WI 53716-3716 2012-10-17
1558638494 Tellurian, Inc. Substance Abuse Rehabilitation Facility 300 Femrite Dr, Monona, WI 53716-3716 2011-11-21
1235302480 Tellurian, Inc. Community/Behavioral Health 300 Femrite Dr, Monona, WI 53716-3716 2008-04-09

Office Location

Street Address 4647 MORMON COULEE RD
City LA CROSSE
State WI
Zip Code 54601-8225

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306902747 Teri Mcdougle Counselor 4647 Mormon Coulee Rd, La Crosse, WI 54601-8225 2006-12-29
1235486598 Sheri Conway Registered Nurse 4647 Mormon Coulee Rd, La Crosse, WI 54601-8225 2012-08-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1891324265 Meagan Mcrae Student in an Organized Health Care Education/Training Program 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 2020-04-07
1255969671 Erin Dingman Student in an Organized Health Care Education/Training Program 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 2020-03-31
1619505047 Nicole Kay Lynch Student in an Organized Health Care Education/Training Program 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 2020-03-31
1174151757 Jenna Sells Student in an Organized Health Care Education/Training Program 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 2020-03-30
1740818301 Katie Irene Tahtinen Student in an Organized Health Care Education/Training Program Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 2020-03-30
1932737517 Margaret May Grimm Student in an Organized Health Care Education/Training Program Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 2020-03-30
1831727312 Matthew Timothy Axler Student in an Organized Health Care Education/Training Program 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 2020-03-30
1093340473 Denise Stinson Technician 1311 Badger St, Apt 505, La Crosse, WI 54601 2020-03-06
1922632397 Ibrahim Ahsan Pharmacist 1105 Wi-16, La Crosse, WI 54601 2020-02-25
1750913356 Liza R Collins Massage Therapist 1415 State Wi 16, La Crosse, WI 54601 2020-02-11
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Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

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
1104207497 Platteville Family Resource Center Community Based Residential Treatment Facility, Mental Illness 155 W Lewis St, Platteville, WI 53818-2103 2015-06-12
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
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Competitor

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City LA CROSSE
Zip Code 54601

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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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