Jessica Riedy

Individual provider Active NPI Developmentally Disabled Services Day Training Agency · Pound, WI

NPI 1346088093 · NPPES record last updated Jul 17, 2024

Key facts

NPI
1346088093
Entity type
Individual (NPI type 1)
Primary specialty
Developmentally Disabled Services Day Training Agency 251C00000X
Practice address
N4470 19TH Rd
Pound, WI 54161-9409
Phone
(920) 591-0526
NPI assigned
Jul 17, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X
Adult Companion 372600000X
Respite Care 385H00000X
Child Physical Disabilities Respite Care 385HR2065X
Developmentally Disabled Services Day Training Agency 251C00000X Yes

Addresses

Primary practice location

N4470 19TH Rd
Pound, WI 54161-9409

Mailing address

N4470 19TH Rd
Pound, WI 54161-9409

Other providers in Pound, WI

All providers in Pound, WI · Developmentally Disabled Services Day Training Agency in Wisconsin

Sources for this page

Verify at the official NPI Registry.