INDIVIDUAL GROWTH SERIVCES, INC.


Address: 1000 N Wisconsin St, Suite 5, Port Washington, WI 53074-1285
Phone: 2622849656

INDIVIDUAL GROWTH SERIVCES, INC. (NPI# 1578935870) 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) 1578935870
Entity Type Organization
Organization Name INDIVIDUAL GROWTH SERIVCES, INC.
Practice Address 1000 N Wisconsin St
Suite 5
Port Washington
WI 53074-1285
Practice Telephone 2622849656
Practice Fax Number 2622844590
Mailing Telephone 2622849656
Mailing Fax Number 2622844590
Enumeration Date 2015-10-26
Last Update Date 2015-10-26
Authorized Official Name SHAWN PATRICK MILES (DIRECTOR)
Authorized Official Telephone 2622849656
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 390237 WI Residential Treatment Facilities

Office Location

Street Address 1000 N WISCONSIN ST
SUITE 5
City PORT WASHINGTON
State WI
Zip Code 53074-1285

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306950902 Celestino F Perez Dentist 1000 N Wisconsin St, Port Washington, WI 53074-1285 2006-08-19
1922299007 Port Chiropractic Inc. Chiropractor 1000 N Wisconsin St, Port Washington, WI 53074-1285 2007-08-05
1801913173 Port Dental Group Sc Durable Medical Equipment & Medical Supplies 1000 N Wisconsin St, Port Washington, WI 53074-1285 2007-03-23
1548372576 David C. Reif Chiropractor 1000 N Wisconsin St, Port Washington, WI 53074-1285 2006-08-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1962045864 Heather Kay Brede Technician 857 Ashley Avenue, Port Washington, WI 53074 2019-10-23
1780062034 Amanda Zitzer Specialist/Technologist 1037 S Spring Street, Apt 257, Port Washington, WI 53074 2015-05-07
1639507643 Kelly Mulder Occupational Therapy Assistant 138 E Prospect St, Port Washington, WI 53074 2013-10-30
1235310921 Susan Ann Dobberpuhl Occupational Therapist 306 N Sprint St, Port Washington, WI 53074 2007-11-21
1245444736 Lee B Raffel Social Worker 3632 E Norport Drive, Port Washington, WI 53074 2007-05-10
1023143708 Joshua E Leute Dentist 1317 West Grand Avenue, Port Washington, WI 53074 2007-02-22
1578633806 Robert Andrew Kortsch Dentist 457 W Grand Ave, Port Washington, WI 53074 2006-11-08
1538256409 Daniel P Witkowski Dentist 1612 N Wisconsin St, Port Washington, WI 53074 2006-10-10
1477584878 Francine L Cosner Obstetrics & Gynecology 1777 W Grand Avenue, Port Washington, WI 53074 2006-07-05
1013953926 Port Washington Podiatry Inc Podiatrist 1317 W Grand Avenue, Port Washington Podiatry, Port Washington, WI 53074 2006-06-20
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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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
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Competitor

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City PORT WASHINGTON
Zip Code 53074

Improve Information

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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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