WILLOW CREEK RANCH, INC. (NPI# 1417334988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417334988 |
| Entity Type | Organization |
| Organization Name | WILLOW CREEK RANCH, INC. |
| Practice Address |
7404 Northwest Hwy # 83 Mukwonago WI 53149-8903 |
| Practice Telephone | 4147912509 |
| Mailing Telephone | 4147912509 |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-05-05 |
| Authorized Official Name | JENNIFER S. PAPE (FOUNDER/EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4147912509 |
| Authorized Official Credential | REGISTERED INSTR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
091707 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 091707 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | WILLOW CREEK RANCH, INC. | 320 Nanticoke Road, Maine, Ny 13802 |
| Street Address |
7404 NORTHWEST HWY # 83 |
| City | MUKWONAGO |
| State | WI |
| Zip Code | 53149-8903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720433790 | Orthopaedic Associates of Wisconsin Sc | Physical Medicine & Rehabilitation | 1231 S Rochester St Ste 100, Mukwonago, WI 53149 | 2016-04-27 |
| 1952724304 | Therapeutic Healing, LLC | Clinic/Center | S77 W30705 Mosher Dr., Mukwonago, WI 53149 | 2014-01-21 |
| 1659667087 | Joan Maria Stevenson | Occupational Therapist | 111 Aktinson St., Unit 2, Mukwonago, WI 53149 | 2011-06-23 |
| 1770873515 | Kimberly Lynn Schmor | Licensed Practical Nurse | 833 Pinehurst Dr, Mukwonago, WI 53149 | 2011-04-13 |
| 1952619959 | Jennifer Ann Crnkovich | Nurse Practitioner | W307 S7835 Applewood Lane, Mukwonago, WI 53149 | 2010-09-24 |
| 1841460839 | Wendy Schmidt | Occupational Therapist | 1231 S Rochester St Ste 210, Mukwonago, WI 53149 | 2008-03-05 |
| 1659589570 | Pamela Ann Mcwilliams | Dentist | 603 North Rochester St., Mukwonago, WI 53149 | 2007-05-21 |
| 1891823787 | Rosalind J Boyer-cole | Anesthesiology | S86w26640 Rustic View Ln, Mukwonago, WI 53149 | 2007-03-01 |
| 1184777435 | Michael F Connor | Dentist | 603 N Rochester Street, Mukwonago, WI 53149 | 2007-01-19 |
| 1912057159 | Leah Mary Hudson | Occupational Therapist | 103 Apollo Ct, Mukwonago, WI 53149 | 2007-01-11 |
| Find all providers in zip 53149 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831754167 | Asap-behavioral Health, Sc | Clinic/Center | 11380 W Theo Trekr Way, West Allis, WI 53214-1135 | 2019-05-02 |
| 1003375049 | Sj Counseling Services, LLC | Clinic/Center | 7726 N 80th St, Milwaukee, WI 53223-3810 | 2019-03-19 |
| 1295224657 | Northwest Counseling & Guidance Clinic | Clinic/Center | 123 S Van Buren, Green Bay, WI 54301-4441 | 2018-05-01 |
| 1801308218 | Northwest Counseling & Guidance Clinic | Clinic/Center | 915 Acacia Ln, Rhinelander, WI 54501-2806 | 2017-10-26 |
| 1790143667 | Northwest Counseling & Guidance Clinic | Clinic/Center | 1201 North 28th Street, Northwest Journey - Northern Lights, Superior, WI 54880-8556 | 2016-02-05 |
| 1770985467 | Northwest Counseling & Guidance Clinic | Clinic/Center | 16092 Highway 63, Hayward, WI 54843-9775 | 2014-09-24 |
| 1700018389 | Saris Counseling LLC | Clinic/Center | 3416 Association Dr, Appleton, WI 54914 | 2009-08-17 |
| 1467626606 | Impact Counseling Services, LLC | Clinic/Center | 301 Ellis Ave, Suite 1, Ashland, WI 54806-1667 | 2008-04-18 |
| 1891976478 | Future Thoughts | Clinic/Center | 2623 N 53rd St, Milwaukee, WI 53210-2326 | 2007-11-24 |
| 1982821575 | Northwest Counseling and Guidance - Northwest Journey - Superior | Clinic/Center | 1419 Hill Ave Ste B, Superior, WI 54880-1951 | 2007-04-18 |
| Find all providers with the same taxonomy | ||||
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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.