TELLURIAN, INC. (NPI# 1609129410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609129410 |
| 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 | 6084631440 |
| Mailing Telephone | 6082227311 |
| Mailing Fax Number | 6084631440 |
| Enumeration Date | 2012-10-17 |
| 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 | WI | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Dane County 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 |
| 1437401338 | Tellurian, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4647 Mormon Coulee Rd, La Crosse, WI 54601-8225 | 2012-10-03 |
| 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 |
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 | 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407170814 | Gregory John Matysik | Community Based Residential Treatment Facility, Mental Illness | 300 Femrite Dr, Monona, WI 53716-3716 | 2010-03-15 |
| 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 |
| 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.