Campbell House LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

0014785 Issued in WI

Legal business name

CAMPBELL HOUSE LLC

Practice address

7197 Loper Rd
Sauk City, WI 53583-9552

Phone

(608) 643-3113

NPI assigned

Jan 2, 2014

Last updated

Jan 2, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gretchen Timmerman

Title

Administrator

Phone

(608) 393-0707

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1598186991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7197 LOPER RD",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "535839552",
            "telephone_number": "608-643-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7197 LOPER RD",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "535839552",
            "telephone_number": "608-643-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "TIMMERMAN",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "608-393-0707"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "WI",
            "license": "0014785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Sauk City, WI
• Providers in Sauk City, WI by specialty
• Mental Illness Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.