1497070700 NPI number — UPLAND HILLS HEALTH, INC

Table of content: (NPI 1497070700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497070700 NPI number — UPLAND HILLS HEALTH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPLAND HILLS HEALTH, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UPLAND HILLS HEALTH THERAPY OUTREACH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497070700
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 COMPASSION WAY
Provider Second Line Business Mailing Address:
PO BOX 800
Provider Business Mailing Address City Name:
DODGEVILLE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53533-1956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-930-8000
Provider Business Mailing Address Fax Number:
608-930-7251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
156 W JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING GREEN
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53588-8005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-588-2600
Provider Business Practice Location Address Fax Number:
608-588-2644
Provider Enumeration Date:
03/30/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SCHNEDLER
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
608-930-7200

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1056 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225X00000X , with the licence number: 1053 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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