JESSIE CRAWFORD RECOVERY CENTER, INC. (NPI# 1124372586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124372586 |
| Entity Type | Organization |
| Organization Name | JESSIE CRAWFORD RECOVERY CENTER, INC. |
| Practice Address |
2101 N Sherman Ave Madison WI 53704-3932 |
| Mailing Address |
1213 N Sherman Ave #323 Madison WI 53704-4236 |
| Practice Telephone | 6082414285 |
| Practice Fax Number | 6082414286 |
| Mailing Telephone | 6084679134 |
| Mailing Fax Number | 6084679135 |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | MS. LORA HUDSON (OFFICE MANAGER) |
| Authorized Official Telephone | 6082414285 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
2986 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1124372586 | 05 |
| Street Address |
2101 N SHERMAN AVE |
| City | MADISON |
| State | WI |
| Zip Code | 53704-3932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174136832 | Richard L Bryant | Counselor | 2101 N Sherman Ave, Madison, WI 53704-3932 | 2020-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407369614 | Joseph Michael Oakley II | Chiropractor | 2801 International Ln Ste 102, Madison, WI 53704 | 2017-11-09 |
| 1972015048 | Suzanne Lee | Psychiatry & Neurology | 1835 Winnebago St. #402, Madison, WI 53704 | 2017-10-30 |
| 1831554021 | Gideon Kazah | Licensed Practical Nurse | 2488 Dahle Street, Madison, WI 53704 | 2015-12-15 |
| 1174952220 | Group Health Cooperative of South Central Wisconsin Madison College | Durable Medical Equipment & Medical Supplies | 1705 Hoffman Street, Madison, WI 53704 | 2013-11-08 |
| 1407190127 | Ashley Marie Snyder | Social Worker | 5203 Autumn Leaf Lane, Apt. 389, Madison, WI 53704 | 2012-11-19 |
| 1619230638 | Dawn Lynette Butts | Optometrist | 4208 E Washington Ave, Madison, WI 53704 | 2012-06-25 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1578730412 | St. Charles Youth & Family Services | Community Based Residential Treatment Facility, Mental Illness | 310 Troy Dr, Cottage B, Madison, WI 53704 | 2008-05-09 |
| 1538346960 | Elizabeth Ann Reiser-loeber | Dentist | 1001 N. Sherman Ave, Madison, WI 53704 | 2008-01-28 |
| 1861683088 | Stephen Dale Flach | Internal Medicine | Covance, 3402 Kinsman Blvd, Madison, WI 53704 | 2007-08-05 |
| Find all providers in zip 53704 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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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.