TELLURIAN, INC. (NPI# 1558638494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558638494 |
| Entity Type | Organization |
| Organization Name | TELLURIAN, INC. |
| Other Organization Name | TELLURIAN UCAN, INC |
| Practice Address |
300 Femrite Dr Monona WI 53716-3716 |
| Practice Telephone | 6082227311 |
| Practice Fax Number | 6082220453 |
| Mailing Telephone | 6082227311 |
| Mailing Fax Number | 6082220453 |
| Enumeration Date | 2011-11-21 |
| 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 | 324500000X | Substance Abuse Rehabilitation Facility | WI | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Tellurian Adult Residential Program | 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 |
| 1437401338 | Tellurian, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4647 Mormon Coulee Rd, La Crosse, WI 54601-8225 | 2012-10-03 |
| 1235302480 | Tellurian, Inc. | Community/Behavioral Health | 300 Femrite Dr, Monona, WI 53716-3716 | 2008-04-09 |
| Street Address |
300 FEMRITE DR |
| City | MONONA |
| State | WI |
| Zip Code | 53716-3716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740213776 | Tellurian, Inc. | Community/Behavioral Health | 300 Femrite Dr, Monona, WI 53716-3716 | 2006-07-10 |
| 1801493994 | Caitlin Mary Clifford | Counselor | 300 Femrite Dr, Monona, WI 53716-3798 | 2020-10-02 |
| 1831756428 | Rebecca J Kienbaum | Counselor | 300 Femrite Dr, Monona, WI 53716-3716 | 2019-05-20 |
| 1598223455 | Heather E Schneider | Counselor | 300 Femrite Dr, Monona, WI 53716-3798 | 2019-03-08 |
| 1063998508 | Lindsey Resendiz | Counselor | 300 Femrite Dr, Monona, WI 53716-3798 | 2018-07-18 |
| 1992202360 | Jennifer R Klawitter | Counselor | 300 Femrite Dr, Monona, WI 53716-3798 | 2018-04-11 |
| 1164929253 | James E Kilgore | Counselor | 300 Femrite Dr, Monona, WI 53716-3716 | 2018-04-06 |
| 1861899718 | Kristina Modaff | Counselor | 300 Femrite Dr, Monona, WI 53716-3716 | 2014-11-20 |
| 1558766949 | Jack Gieche | Counselor | 300 Femrite Dr, Monona, WI 53716 | 2014-10-28 |
| 1710314281 | Casey Elizabeth Simons | Counselor | 300 Femrite Dr, Monona, WI 53716-3716 | 2013-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730738873 | Richard Onyait | Technician | 1103 Birch Haven Cir, Monona, WI 53716 | 2019-09-11 |
| 1962950428 | Paige Corliss | Pharmacist | 1821 S. Stoughton Road, Madison, WI 53716 | 2016-09-13 |
| 1760840946 | Stacey Palermo | Marriage & Family Therapist | 303 Frost Woods Rd, Monona, WI 53716 | 2016-02-03 |
| 1326414442 | Diane Marie Kelley | Nurse Practitioner | 300 Femrite Drive, Monona, WI 53716 | 2015-08-12 |
| 1942692520 | Kelsey Lynn Markham | Counselor | 5900 Monona Drive, Suite 100, Monona, WI 53716 | 2015-02-19 |
| 1225452733 | Nicole Moscinski | Marriage & Family Therapist | 6117 Monona Dr Ste 1b, Monona, WI 53716 | 2014-02-05 |
| 1013345644 | Emma Amanda Rose | Physician Assistant | 521 Bowman Ave., Madison, WI 53716 | 2013-10-16 |
| 1407154271 | Jennifer Orshak | Registered Nurse | 5410 Forge Drive, Madison, WI 53716 | 2011-03-03 |
| 1982906525 | Jennifer Chun | Dentist | 100 River Pl Ste 110, Monona, WI 53716 | 2010-12-02 |
| 1609041987 | Jennifer A Britain | Physical Therapist | 1821 South Stoughton Rd, Madison, WI 53716 | 2008-04-28 |
| Find all providers in zip 53716 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
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| 1306298740 | Phoenix Counseling | Substance Abuse Rehabilitation Facility | 64 S 4th St, Barron, WI 54812-1503 | 2016-07-11 |
| 1043684251 | Millenium Manor, LLC | Substance Abuse Rehabilitation Facility | 4509 Arthur Rd, Slinger, WI 53086-9603 | 2015-11-25 |
| 1780081174 | Psthways To A Better Life 1, LLC | Substance Abuse Rehabilitation Facility | 13111 Lax Chapel Rd, Kiel, WI 53042-3954 | 2014-12-01 |
| 1710304878 | Exodus Transitional Care Facility Inc. | Substance Abuse Rehabilitation Facility | 1421 Fond Du Lac Ave, Kewaskum, WI 53040-9136 | 2014-03-26 |
| 1558798686 | Friends of Women In Recovery Inc. | Substance Abuse Rehabilitation Facility | 166 S Park Ave, Fond Du Lac, WI 54935-4441 | 2013-10-03 |
| 1457784662 | The Pines Treatment & Recovery Center | Substance Abuse Rehabilitation Facility | N3387 State Road 73, Wautoma, WI 54982-5257 | 2013-08-12 |
| 1215375472 | Hope Haven | Substance Abuse Rehabilitation Facility | 3602 Memorial Dr, Madison, WI 53704-1106 | 2013-06-10 |
| 1831464536 | Alcocare Inc. | Substance Abuse Rehabilitation Facility | 786 S Main St, Janesville, WI 53545-4852 | 2012-03-13 |
| 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.