Provider Demographics
NPI:1518254945
Name:THERAPEUTIC HOME SERVICES
Entity Type:Organization
Organization Name:THERAPEUTIC HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:608-366-1269
Mailing Address - Street 1:9484 FESTIVAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656
Mailing Address - Country:US
Mailing Address - Phone:608-366-1269
Mailing Address - Fax:608-781-4204
Practice Address - Street 1:9484 FESTIVAL AVENUE
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656
Practice Address - Country:US
Practice Address - Phone:608-366-1269
Practice Address - Fax:608-781-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3666-026305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service