Center for Independent Living for Western Wisconsin

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

CENTER FOR INDEPENDENT LIVING FOR WESTERN WISCONSIN

Practice address

2920 Schneider Ave SE
Menomonie, WI 54751-2331

Phone

(715) 233-1070

Fax

(715) 233-1083

NPI assigned

Oct 16, 2008

Organization subpart

No

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

Authorized official

Name

Tammy Grage

Title

HR/Fiscal Manager

Phone

(715) 233-1070

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1710139159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 SCHNEIDER AVE SE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512331",
            "telephone_number": "715-233-1070",
            "fax_number": "715-233-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 SCHNEIDER AVE SE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512331",
            "telephone_number": "715-233-1070",
            "fax_number": "715-233-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INDEPENDENT LIVING FOR WESTERN WISCONSIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "GRAGE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "HR/FISCAL MANAGER",
        "authorized_official_telephone_number": "715-233-1070"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43105700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Menomonie, WI
• Providers in Menomonie, WI by specialty
• Case Management Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.

Verify at the official NPI Registry.