United Church Camps, Inc.

Primary specialty

Respite Care CampTaxonomy code 385HR2050X

Legal business name

UNITED CHURCH CAMPS, INC.

Doing business as

Camp AweSum
Moon Beach
Moon Beach/Camp AweSum1 more in Other names

Practice address

1487 Moon Beach LN
Saint Germain, WI 54558-9259

Phone

(715) 479-8255

NPI assigned

Aug 7, 2018

Organization subpart

No

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

Authorized official

Name

Eric Olsen

Title

Managing Director

Phone

(715) 479-8255

Specialties & licenses 1

Addresses

Other names 4

• Camp AweSum Doing business as
• Moon Beach Doing business as
• Moon Beach/Camp AweSum Doing business as
• Pilgrim Center Doing business as

Locations

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1528547973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1487 MOON BEACH LN",
            "city": "SAINT GERMAIN",
            "state": "WI",
            "postal_code": "545589259",
            "telephone_number": "715-479-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1487 MOON BEACH LN",
            "city": "SAINT GERMAIN",
            "state": "WI",
            "postal_code": "545589259",
            "telephone_number": "715-479-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CHURCH CAMPS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "715-479-8255"
    },
    "taxonomies": [
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camp AweSum",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moon Beach",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moon Beach/Camp AweSum",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pilgrim Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gina Marie Schmolze, LPN
• Danielle Schramm
• Craig Richard Smith, RPH
• Town of St. Germain
• Zachary Troyer, D..O.

• Respite Care in Saint Germain, WI
• Providers in Saint Germain, WI by specialty
• Respite Care in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.