Provider Demographics
NPI: | 1558816132 |
---|---|
Name: | OFFERING HOPE THERAPIES, INC. |
Entity Type: | Organization |
Organization Name: | OFFERING HOPE THERAPIES, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT, OFFERING HOPE THERAPIES, |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | HEIDI |
Authorized Official - Middle Name: | JO |
Authorized Official - Last Name: | SOVACOOL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OTR |
Authorized Official - Phone: | 715-403-3566 |
Mailing Address - Street 1: | 516 E 2ND ST S |
Mailing Address - Street 2: | |
Mailing Address - City: | LADYSMITH |
Mailing Address - State: | WI |
Mailing Address - Zip Code: | 54848-1850 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 715-532-9718 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 711 W 9TH ST N |
Practice Address - Street 2: | |
Practice Address - City: | LADYSMITH |
Practice Address - State: | WI |
Practice Address - Zip Code: | 54848-1252 |
Practice Address - Country: | US |
Practice Address - Phone: | 715-403-3566 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-08-24 |
Last Update Date: | 2016-08-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WI | 343726 | 261QR0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |