NPIMap

Organization Active NPI

Tellurian, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • La Crosse, WI
National Provider Identifier
1437401338
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
0013220 Issued in WI
Legal business name
TELLURIAN, INC.
Practice address
4647 Mormon Coulee Rd
La Crosse, WI 54601-8225
Phone
(608) 519-3080
Fax
(608) 519-3083
NPI assigned
Oct 3, 2012
Organization subpart
Yes
Parent organization
TELLURIAN, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Erica L Mueller
Title
Quality Assurance Director
Phone
(608) 204-8547

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 0013220 WI Primary

Addresses

Primary practice location

4647 Mormon Coulee Rd
La Crosse, WI 54601-8225

Mailing address

4647 Mormon Coulee Rd
La Crosse, WI 54601-8225
Phone (608) 519-3080

Other names 2

  • Tellurian UCAN, inc. Former legal business name
  • La Crosse CARE Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Tellurian Inc10 organizations share this tax ID, including this one
Part of
Tellurian Inc

Other organizations with this tax ID 9

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

Locations

4647 Mormon Coulee Rd
La Crosse, WI 54601
Phone (608) 519-3080

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1437401338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4647 MORMON COULEE RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018225",
            "telephone_number": "608-519-3080",
            "fax_number": "608-519-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 MORMON COULEE RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018225",
            "telephone_number": "608-519-3080",
            "fax_number": "608-519-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELLURIAN, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TELLURIAN, INC.",
        "enumeration_date": "2012-10-03",
        "last_updated": "2022-08-15",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "MUELLER",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "QUALITY ASSURANCE DIRECTOR",
        "authorized_official_telephone_number": "608-204-8547"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "WI",
            "license": "0013220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tellurian UCAN, inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "La Crosse CARE Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.