Provider Demographics
NPI:1982004578
Name:MADISON AREA REHABILITATION CENTERS, INC
Entity Type:Organization
Organization Name:MADISON AREA REHABILITATION CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-223-9110
Mailing Address - Street 1:901 POST RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-3260
Mailing Address - Country:US
Mailing Address - Phone:608-223-9110
Mailing Address - Fax:608-223-9112
Practice Address - Street 1:901 POST RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-3260
Practice Address - Country:US
Practice Address - Phone:608-223-9110
Practice Address - Fax:608-223-9112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41482000Medicaid