Provider Demographics
NPI:1679821839
Name:UPLAND HILLS HEALTH, INC.
Entity Type:Organization
Organization Name:UPLAND HILLS HEALTH, INC.
Other - Org Name:UPLAND HILLS HEALTH CLINIC - MONTFORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINSTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHNEDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-930-7200
Mailing Address - Street 1:202 W US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:MONTFORT
Mailing Address - State:WI
Mailing Address - Zip Code:53569-9452
Mailing Address - Country:US
Mailing Address - Phone:608-943-6308
Mailing Address - Fax:608-943-8408
Practice Address - Street 1:202 W US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:MONTFORT
Practice Address - State:WI
Practice Address - Zip Code:53569-9452
Practice Address - Country:US
Practice Address - Phone:608-943-6308
Practice Address - Fax:608-943-8408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-20
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIWI1085OtherMEDICARE PTAN