Provider Demographics
NPI:1669144135
Name:BADGER WELLNESS
Entity type:Organization
Organization Name:BADGER WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-345-5684
Mailing Address - Street 1:2810 CROSSROADS DR
Mailing Address - Street 2:SUITE 4000 #1827
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718
Mailing Address - Country:US
Mailing Address - Phone:608-345-5684
Mailing Address - Fax:
Practice Address - Street 1:2810 CROSSROADS DR
Practice Address - Street 2:SUITE 4000 #1827
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718
Practice Address - Country:US
Practice Address - Phone:608-345-5684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care