Endeavors Adult Development Center

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

ENDEAVORS ADULT DEVELOPMENT CENTER

Practice address

101 150TH St
Balsam Lake, WI 54810-8011

Phone

(715) 485-8764

Fax

(715) 485-8740

NPI assigned

Dec 22, 2015

Last updated

Dec 22, 2015By 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

Kathleen S Clark

Title

Director

Phone

(715) 485-8764

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1831554609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 150TH ST",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548108011",
            "telephone_number": "715-485-8764",
            "fax_number": "715-485-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 150TH ST",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548108011",
            "telephone_number": "715-485-8764",
            "fax_number": "715-485-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVORS ADULT DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-485-8764"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta J Carlson, MS, LMFT, LSW
• Nancy J Christie, BA
• Kathleen S Clark, LSW
• Elizabeth Frances Ebensperger, PHARMD
• Gary P Ehrich, CSAC, ICS
• Charles Paul Erickson, R.PH.
• Jana Ranee' Hutchinson Fischer
• John Hale, LSW
• Kathleen M Herbison Kisting, CSAC
• Angela Joy, LSW

• Adult Day Care Clinic/Center in Balsam Lake, WI
• Providers in Balsam Lake, WI by specialty
• Adult Day Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.