Provider Demographics
NPI:1134883200
Name:SATORI HOUSE RECOVERY INC
Entity type:Organization
Organization Name:SATORI HOUSE RECOVERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:NIESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-335-5933
Mailing Address - Street 1:309 OAK CREST AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2736
Mailing Address - Country:US
Mailing Address - Phone:414-335-5933
Mailing Address - Fax:
Practice Address - Street 1:102 4TH AVE
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-2175
Practice Address - Country:US
Practice Address - Phone:606-433-7329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty