Provider Demographics
NPI:1407095151
Name:REM WISCONSIN, INC
Entity Type:Organization
Organization Name:REM WISCONSIN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-388-5150
Mailing Address - Street 1:2005 W BELTLINE HWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2314
Mailing Address - Country:US
Mailing Address - Phone:608-276-1191
Mailing Address - Fax:608-276-1184
Practice Address - Street 1:2005 W BELTLINE HWY
Practice Address - Street 2:SUITE 203
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2314
Practice Address - Country:US
Practice Address - Phone:608-276-1191
Practice Address - Fax:608-276-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care