Provider Demographics
NPI:1528409109
Name:WHEATON FRANCISCAN HEALTHCARE-ALL SAINTS FOUNDATION INC
Entity Type:Organization
Organization Name:WHEATON FRANCISCAN HEALTHCARE-ALL SAINTS FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:262-687-2436
Mailing Address - Street 1:3621 5 MILE RD APT A
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-9571
Mailing Address - Country:US
Mailing Address - Phone:262-902-7493
Mailing Address - Fax:
Practice Address - Street 1:3621 5 MILE RD APT A
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53402-9571
Practice Address - Country:US
Practice Address - Phone:262-902-7493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHEATON FRANCISCAN HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital