NPIMap

Organization Active NPI

Platteville Family Resource Center

Doing business as SW WI Regional Elem Therapeutic Classroom

  • Mental Illness Community Based Residential Treatment Facility
  • Platteville, WI
National Provider Identifier
1104207497
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
PLATTEVILLE FAMILY RESOURCE CENTER
Doing business as
SW WI Regional Elem Therapeutic Classroom
Practice address
155 W Lewis St
Platteville, WI 53818-2103
Phone
(608) 642-1563
Fax
(608) 348-4191
NPI assigned
Jun 12, 2015
Last updated
Aug 4, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
PLATTEVILLE FAMILY RESOURCE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Dr. Marc Wruble, PH.D.NPI 1427064237
Title
Director
Phone
(608) 348-4060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

155 W Lewis St
Platteville, WI 53818-2103

Mailing address

PO Box 36
Platteville, WI 53818-0036
Phone (608) 348-4060

Other identifiers 1

IdentifierTypeStateIssuer
39757000MedicaidWI

Other names 1

  • SW WI Regional Elem Therapeutic Classroom Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Platteville Family Resource2 organizations share this tax ID, including this one
Part of
Platteville Family Resource

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

155 W Lewis St
Platteville, WI 53818
Phone (608) 642-1563

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1104207497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538180036",
            "telephone_number": "608-348-4060",
            "fax_number": "608-348-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W LEWIS ST",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538182103",
            "telephone_number": "608-642-1563",
            "fax_number": "608-348-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATTEVILLE FAMILY RESOURCE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLATTEVILLE FAMILY RESOURCE CENTER",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "WRUBLE",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "608-348-4060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39757000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SW WI Regional Elem Therapeutic Classroom",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Platteville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.