LORI KNAPP FOND DU LAC, INC (NPI# 1679721435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679721435 |
| Entity Type | Organization |
| Organization Name | LORI KNAPP FOND DU LAC, INC |
| Practice Address |
625 Fond Du Lac Ave Fond Du Lac WI 54935 |
| Practice Telephone | 9209070949 |
| Practice Fax Number | 9209070961 |
| Mailing Telephone | 9209070949 |
| Mailing Fax Number | 9209070961 |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2008-09-05 |
| Authorized Official Name | DONALD B KNAPP (CEO) |
| Authorized Official Telephone | 6083265536 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
625 FOND DU LAC AVE |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811597933 | Mount Pleasant Homes LLP | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1917 Mount Pleasant St, Racine, WI 53404-2236 | 2020-10-28 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.