Provider Demographics
NPI:1780444000
Name:CLOVER FAMILY SERVICES LLC
Entity type:Organization
Organization Name:CLOVER FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GLOWACKI
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:608-218-4462
Mailing Address - Street 1:21 W MILWAUKEE ST # 103
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2911
Mailing Address - Country:US
Mailing Address - Phone:608-218-4462
Mailing Address - Fax:608-544-8110
Practice Address - Street 1:23 W MILWAUKEE ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2981
Practice Address - Country:US
Practice Address - Phone:608-448-6116
Practice Address - Fax:608-544-8110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No385HR2050XRespite Care FacilityRespite CareRespite Care CampGroup - Multi-Specialty