Red Road House

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Legal business name

RED ROAD HOUSE

Practice address

152 S Locust St
Janesville, WI 53548-3767

Phone

(608) 756-9252

NPI assigned

Sep 26, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss William Grahn

Title

Founder/Director

Phone

(608) 756-2592

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1023527769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 S LOCUST ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483767",
            "telephone_number": "608-756-2592",
            "fax_number": "608-756-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 S LOCUST ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483767",
            "telephone_number": "608-756-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED ROAD HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-26",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "GRAHN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "FOUNDER/DIRECTOR",
        "authorized_official_telephone_number": "608-756-2592",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prevention Professional",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISCONSIN DEPARTMENT OF HEALTH SERVICES",
            "identifier": "0016168",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa L Rauscher, PT
• Ashley Sue Ray
• Hasan Raza, PA-C
• Jill Reasa, APSW
• Dawn M. Recker, PHARM.D.
• Anne Marie Reed, MD
• Betsy L Reed, LCSW
• Heather Margrethe Reed, APNP
• Kimberly Ann Reed
• Neal R. Reed, L.C.S.W.

• Prevention Professional in Janesville, WI
• Providers in Janesville, WI by specialty
• Prevention Professional in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.