Everwild Therapy & Wellness

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

EVERWILD THERAPY & WELLNESS

Practice address

1896 County Hwy NN
West Bend, WI 53095-9712

Phone

(414) 688-8888

NPI assigned

Oct 1, 2026

Last updated

Oct 1, 2026By 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

Nicole Balistreri, MS, OT

Title

Co-Founder/Occupational Therapist

Phone

(262) 208-5087

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790812800000",
    "number": "1720992076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 ELKHART DR APT 319",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531898820",
            "telephone_number": "262-208-5087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1896 COUNTY HWY NN",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959712",
            "telephone_number": "414-688-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1171 Limerick Ln",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "WI",
            "postal_code": "530279731",
            "country_code": "US",
            "telephone_number": "262-208-5087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVERWILD THERAPY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "BALISTRERI",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CO-FOUNDER/OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "262-208-5087",
        "authorized_official_credential": "MS, OT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eric Everson
• Everwild
• Eye Care Optical Inc.
• Falkowski Chiropractic Clinic LLC
• Patrick J Falkowski, D.C.
• Family Hearing Care, LLC
• Leah Marie Fax, DDS

• Rehabilitation Clinic/Center in West Bend, WI
• Providers in West Bend, WI by specialty
• Rehabilitation Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.