TELLURIAN, INC. (NPI# 1437401338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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. |
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 Name | Type Code |
---|---|
La Crosse CARE Center | Other Name - Individual/Organization |
Tellurian UCAN, inc. | Former Legal Business Name - Organization |
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 |
Street Address |
4647 MORMON COULEE RD |
City | LA CROSSE |
State | WI |
Zip Code | 54601-8225 |
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 |
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 |
Find all providers in zip 54601 |
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] |
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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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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.