Organization Active NPI

The Threshold Incorporated

  • Developmentally Disabled Services Day Training Agency
  • West Bend, WI
National Provider Identifier
1821245390
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
THE THRESHOLD INCORPORATED
Practice address
600 Rolfs Ave
West Bend, WI 53090-2637
Phone
(262) 338-1188
Fax
(262) 338-9453
NPI assigned
Aug 26, 2008
Last updated
Aug 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Authorized official

Name
Mr. Thomas R Bergerud
Title
Executive Director
Phone
(262) 338-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

600 Rolfs Ave
West Bend, WI 53090-2637

Mailing address

600 Rolfs Ave
West Bend, WI 53090-2637
Phone (262) 338-1188

Other identifiers 1

IdentifierTypeStateIssuer
41204800MedicaidWI

National Provider Directory

National Provider Directory

Locations

600 Rolfs Ave
West Bend, WI 53090
Phone (262) 338-1188

NPI Registry JSON

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1821245390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ROLFS AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530902637",
            "telephone_number": "262-338-1188",
            "fax_number": "262-338-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROLFS AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530902637",
            "telephone_number": "262-338-1188",
            "fax_number": "262-338-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE THRESHOLD INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "BERGERUD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "262-338-1188",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41204800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.