Provider Demographics
NPI:1548594005
Name:HODAN CENTER,INC
Entity Type:Organization
Organization Name:HODAN CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRAEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-987-3336
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:MINERAL POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53565-0212
Mailing Address - Country:US
Mailing Address - Phone:608-987-3336
Mailing Address - Fax:608-987-3082
Practice Address - Street 1:941 FOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:MINERAL POINT
Practice Address - State:WI
Practice Address - Zip Code:53565-1313
Practice Address - Country:US
Practice Address - Phone:608-987-3336
Practice Address - Fax:608-987-3082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41421500Medicaid