Fennimore Healing Arts, LLC
Organization Active NPI Community/Behavioral Health Agency · Fennimore, WI
NPI 1881024404 · NPPES record last updated Mar 31, 2016
Key facts
- NPI
- 1881024404
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 4062-33 (WI)
- Legal business name
- FENNIMORE HEALING ARTS, LLC
- Practice address
- 770 Lincoln Ave
Suite 2
Fennimore, WI 53809-1562 - Phone
- (608) 572-3494
- Fax
- (608) 822-3812
- NPI assigned
- Nov 18, 2013
- Organization subpart
- No
Authorized official
- Name
- Rita Lease, APNP, PMHNP-BC
- Title
- Nurse Practioner
- Phone
- (608) 572-3494
Practitioners 1
-
Rita M. Lease, PMHNP-BC
National Provider Directory
Locations
770 Lincoln Ave
Ste 2
Fennimore, WI 53809
Phone (608) 572-3494
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 4062-33 | WI | Yes |
Addresses
Primary practice location
770 Lincoln Ave
Suite 2
Fennimore, WI 53809-1562
Mailing address
770 Lincoln Ave
Suite 2
Fennimore, WI 53809-1562
Phone (608) 572-3494
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 849190006 | Other | WI | MEDICARE PTAN |
| 1215243852 | Medicaid | WI |
Other providers in Fennimore, WI
- Divine Rehabilitation and Nursing at Fennimore LLC
- Courtney Draude
- Fennimore Area Rescue Squad Inc
- Fennimore Community Schools
- Fennimore Dental, LLC
- Fennimore SNF Operations, LLC
- Andrew Thomas Fessler
- Stephanie Elin Foster
- Ashlyn Jo Boebel Fritche
- Kylee Gardner
All providers in Fennimore, WI · Community/Behavioral Health Agency in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.