Provider Demographics
NPI:1649420076
Name:QUALITY THERAPY, LLC
Entity Type:Organization
Organization Name:QUALITY THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KITELINGER
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:920-462-4583
Mailing Address - Street 1:311 REAUME AVE
Mailing Address - Street 2:
Mailing Address - City:KAUKAUNA
Mailing Address - State:WI
Mailing Address - Zip Code:54130-2430
Mailing Address - Country:US
Mailing Address - Phone:920-462-4583
Mailing Address - Fax:
Practice Address - Street 1:311 REAUME AVE
Practice Address - Street 2:
Practice Address - City:KAUKAUNA
Practice Address - State:WI
Practice Address - Zip Code:54130-2430
Practice Address - Country:US
Practice Address - Phone:920-462-4583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIQ004099320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities