COLONIAL CLUB, INC. (NPI# 1033659669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033659669 |
| Entity Type | Organization |
| Organization Name | COLONIAL CLUB, INC. |
| Practice Address |
301 Blankenheim Ln Sun Prairie WI 53590-2373 |
| Practice Telephone | 6088374611 |
| Practice Fax Number | 6088379302 |
| Mailing Telephone | 6088374611 |
| Mailing Fax Number | 6088379302 |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | ROBERT POWER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6088374611 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251V00000X | Voluntary or Charitable | 265-800 | WI | Agencies |
| Street Address |
301 BLANKENHEIM LN |
| City | SUN PRAIRIE |
| State | WI |
| Zip Code | 53590-2373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194280529 | Kasi Lucas Schroeder | Chiropractor | 110 N Grand Ave, Suite 4, Sun Prairie, WI 53590 | 2019-02-11 |
| 1770053712 | Jamie Engstrom | Psychologist | 3061 Pleasant St, 216, Sun Prairie, WI 53590 | 2018-12-03 |
| 1154837433 | Wisconsin Dental Health, LLC | Dentist | 390 S. Grand Ave, Suite#110, Sun Prairie, WI 53590 | 2017-12-21 |
| 1669981676 | Elizabeth M Gregg | Counselor | 1170 N Bird St, Sun Prairie, WI 53590 | 2017-09-21 |
| 1609298595 | Prairie Lakes Dental | Dentist | 2804 Prairie Lakes Drive, Sun Prairie, WI 53590 | 2014-01-10 |
| 1407297559 | Quality Medical Rides LLC | Non-emergency Medical Transport (VAN) | 2907 Vang Rd, Sun Prairie, WI 53590 | 2013-07-17 |
| 1376892851 | Costco Wholesale Corporation | Pharmacy | 2850 Hoepker Rd, Sun Prairie, WI 53590 | 2012-08-30 |
| 1043454234 | Dean Lewis Drake | Registered Nurse | 7281 County Rd V. V., Sun Prairie, WI 53590 | 2009-05-01 |
| 1679728992 | Dianne Mary Mayr | Registered Nurse | 3181 Nature Dr, Conservancy States Ln, Sun Prairie, WI 53590 | 2008-12-01 |
| 1043462021 | Crown Point Village, LLC | Assisted Living Facility | 881 Liberty Boulevard, Sun Prairie, WI 53590 | 2008-10-21 |
| Find all providers in zip 53590 | ||||
| Taxonomy Code | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
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| 1548826159 | Center for Childhood Safety | Voluntary or Charitable | 842 S Military Ave, Green Bay, WI 54304-2114 | 2019-05-20 |
| 1366005019 | Tim Halbrook Builders, Inc | Voluntary or Charitable | 3681 Monroe Rd, De Pere, WI 54115-8355 | 2019-04-18 |
| 1073072542 | Baraboo River Equine-assisted Therapies Inc. | Voluntary or Charitable | E12311 County Rd W, Baraboo, WI 53913-9668 | 2019-03-14 |
| 1225504335 | Autism Society of South Central Wisconsin | Voluntary or Charitable | 437 S Yellowstone Dr Ste 217a, Madison, WI 53719-1061 | 2018-10-16 |
| 1346742764 | Superior Douglas County Family Ymca | Voluntary or Charitable | 9 N 21st St, Superior, WI 54880-5201 | 2018-03-01 |
| 1295253722 | Allied Horsemanship, Inc | Voluntary or Charitable | 35954 Cypress Ln, Prairie Du Chien, WI 53821-8831 | 2017-09-05 |
| 1508391079 | Lake Area Free Clinic | Voluntary or Charitable | 856 B Armour Road, Oconomowoc, WI 50366 | 2017-04-21 |
| 1093248569 | Association for The Rights of Citizens With Handicaps | Voluntary or Charitable | 419 Frederick St, Waukesha, WI 53186-5605 | 2017-04-11 |
| Find all providers with the same taxonomy | ||||
| City | SUN PRAIRIE |
| Zip Code | 53590 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.