Active NPI
St. Charles Youth & Family Services
- Mental Illness Community Based Residential Treatment Facility
- Madison, WI
National Provider Identifier
1578730412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- 1011445
- Legal business name
- ST. CHARLES YOUTH & FAMILY SERVICES
- Practice address
- 310 Troy Dr
Cottage B
Madison, WI 53704 - Phone
- (608) 663-5910
- NPI assigned
- May 9, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Catherine Connolly
- Title
- President
- Phone
- (414) 476-3710
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | 1011445 | WI | Primary |
Addresses
Primary practice location
310 Troy Dr
Cottage B
Madison, WI 53704
Mailing address
151 S 84TH St
Milwaukee, WI 53214-1456
Phone (414) 476-3710
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43009100 | Medicaid | WI |
National Provider Directory
National Provider Directory- Tax ID family
- St Charles Youth Family Services
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Illness Community Based Residential Treatment Facility
- Wauwatosa, WI
- NPI 1669648960
-
- Adolescent and Children Mental Health Clinic/Center
- Madison, WI
- NPI 1861636672
-
- Community/Behavioral Health Agency
- Milwaukee, WI
- NPI 1942468954
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210291200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210291200000",
"number": "1578730412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 S 84TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532141456",
"telephone_number": "414-476-3710",
"fax_number": "414-778-5985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 TROY DR",
"address_2": "COTTAGE B",
"city": "MADISON",
"state": "WI",
"postal_code": "53704",
"telephone_number": "608-663-5910"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. CHARLES YOUTH & FAMILY SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-09",
"last_updated": "2008-05-09",
"status": "A",
"authorized_official_last_name": "CONNOLLY",
"authorized_official_first_name": "CATHERINE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "414-476-3710",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "WI",
"license": "1011445",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43009100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
- SSM Health Care of Wisconsin, Inc. (SSM Health St. Mary's Hospital-Madison)
- SSM Health Care of Wisconsin, Inc. (St Marys Care Center Pharmacy)
- Brittany Marie St John, OTR
- St Mary's Dean Ventures Inc (Breast Core Biopsy Center)
- St Marys Care and Rehab Center LLC
- St. Charles Youth & Family Services
- Nicole Erin St. Clair, MD
- Pat Ann St. Germain, M.A.
- Jasmine St. John, LMFT
- Thomas John St. Peter
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.