NPIMap

Organization Active NPI

Willowglen Hein Foster Care Group Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Plymouth, WI
National Provider Identifier
1457559262
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
1005423 Issued in WI
Legal business name
WILLOWGLEN HEIN FOSTER CARE GROUP HOME
Practice address
207 Hein Ave
Plymouth, WI 53073-2526
Phone
(920) 893-5132
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jaya Singh, PH.D.
Title
Director Residential Services
Phone
(414) 527-6970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 1005423 WI Primary

Addresses

Primary practice location

207 Hein Ave
Plymouth, WI 53073-2526

Mailing address

207 Hein Ave
Plymouth, WI 53073-2526
Phone (920) 893-5132

National Provider Directory

National Provider Directory
Tax ID family
Willowglen Academy Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457559262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HEIN AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530732526",
            "telephone_number": "920-893-5132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HEIN AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530732526",
            "telephone_number": "920-893-5132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWGLEN HEIN FOSTER CARE GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "JAYA",
        "authorized_official_title_or_position": "DIRECTOR RESIDENTIAL SERVICES",
        "authorized_official_telephone_number": "414-527-6970",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "WI",
            "license": "1005423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.