Blandine House Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1068-800 Issued in WI

Legal business name

BLANDINE HOUSE INC

Practice address

25 N Park Ave
Fond Du Lac, WI 54935-3501

Phone

(920) 922-9487

Fax

(920) 922-9184

NPI assigned

Jul 14, 2011

Last updated

Jul 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James Colwin

Title

Executive Director

Phone

(920) 922-9487

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1285922971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N PARK AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353501",
            "telephone_number": "920-922-9487",
            "fax_number": "920-922-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N PARK AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353501",
            "telephone_number": "920-922-9487",
            "fax_number": "920-922-9184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANDINE HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "COLWIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "920-922-9487",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "WI",
            "license": "1068-800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cortney D Birschbach, OD
• Jennifer H Bissell, MD
• Patrick J Bissell, MD
• Sarah Blaha
• Sydney Li Blaine
• Christopher J Blattner, PT
• Jacquelyn Mae Block, MFT, LCSW, LMFT
• Melanie M. Bloedorn-Hansen, APNP
• Blue Lake Smiles (Blue Lake Smiles Pediatric Dentistry)
• Sean Blum, DPT

• Substance Abuse Rehabilitation Facility in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Substance Abuse Rehabilitation Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.