Provider Demographics
NPI:1720674245
Name:SONGBIRD HEALTH WI LLC
Entity Type:Organization
Organization Name:SONGBIRD HEALTH WI LLC
Other - Org Name:SONGBIRD THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-244-4592
Mailing Address - Street 1:361 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-2617
Mailing Address - Country:US
Mailing Address - Phone:262-236-7614
Mailing Address - Fax:833-392-1148
Practice Address - Street 1:361 FALLS RD
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-2617
Practice Address - Country:US
Practice Address - Phone:262-236-7614
Practice Address - Fax:833-392-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty