WOLF LARSON ENTERPRISES LLC (NPI# 1487151130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487151130 |
| Entity Type | Organization |
| Organization Name | WOLF LARSON ENTERPRISES LLC |
| Practice Address |
1932 Deer Ln Washington IL 61571-9679 |
| Practice Telephone | 3092081288 |
| Mailing Telephone | 3092081288 |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |
| Authorized Official Name | JAMES GIBB (OWNER) |
| Authorized Official Telephone | 3092081288 |
| Authorized Official Credential | LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
1932 DEER LN |
| City | WASHINGTON |
| State | IL |
| Zip Code | 61571-9679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904504 | Kelly Hornberger | Physical Therapist | 1201 Newcastle Rd., Washington, IL 61571 | 2018-09-01 |
| 1073050407 | Jillyn Cross | Occupational Therapist | 14 Oxford Court, Washington, IL 61571 | 2017-01-24 |
| 1639410772 | Stephen L Dejaynes | Counselor | 100 Hillcrest Drive, Washington, IL 61571 | 2013-03-14 |
| 1184998692 | One Counseling and Wellness | Counselor | 1003 North Cummings Lane, Washington, IL 61571 | 2012-03-01 |
| 1871878371 | M Lisa Kim | Pharmacist | 1700 Saddleridge Ct, Washington, IL 61571 | 2011-10-15 |
| 1073805156 | Skill Sprout International | Behavioral Analyst | 102 Walnut Street, Washington, IL 61571 | 2011-05-09 |
| 1659600948 | Skill Sprout, LLC | Behavioral Analyst | 128 Washington Square, Washington, IL 61571 | 2009-12-15 |
| 1700024916 | Julie Adams | Developmental Therapist | 700 S. Elm, Washington, IL 61571 | 2009-01-26 |
| 1851595128 | Michael John Herman | Dentist | 106 So Cummings Lane, Washington, IL 61571 | 2007-06-12 |
| 1861539132 | Gary Lee Cunningham | Dentist | 5 Laurel Ct., Washington, IL 61571 | 2007-01-30 |
| Find all providers in zip 61571 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134728397 | Blueiris LLC | Clinic/Center | 3318 Georgia Ave Nw, Unit 13, Washington, DC 20010 | 2020-10-20 |
| 1962000117 | Espinoza Therapy Pllc | Clinic/Center | 2202 18th St Nw # 304, Washington, DC 20009-1813 | 2020-10-10 |
| 1639711054 | Some, Inc. | Clinic/Center | 1509 N Capitol St Ne, Washington, DC 20002-3343 | 2019-10-17 |
| 1841779782 | Capitol Hill Therapy LLC | Clinic/Center | 1002 E Capitol St Ne, Washington, DC 20003-3906 | 2018-08-10 |
| 1700389319 | The Aakoma Center, Pllc | Clinic/Center | 3000 Connecticut Ave Nw Apt 436, Washington, DC 20008-2556 | 2018-03-10 |
| 1043762941 | Trinity Services | Clinic/Center | 4401 Brooks St Ne, Washington, DC 20019-4606 | 2016-10-27 |
| 1942578133 | Psi Services IIi, Inc. | Clinic/Center | 770 M Street Se, Washington, DC 20003-3609 | 2011-12-02 |
| 1336301407 | Community Action Group | Clinic/Center | 3325 13th St Se, Washington, DC 20032-4533 | 2008-06-30 |
| 1205000585 | Wooded Acres Guest Home Inc | Clinic/Center | 3622 Cherry Road, Washington, NC 27889-7268 | 2008-04-17 |
| 1144839671 | Keeping Therapy Close, LLC | Clinic/Center | 100 M St Se Ste 600, Washington, DC 20003-3648 | 2020-07-30 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 61571 |
Please comment or provide details below to improve the information on WOLF LARSON ENTERPRISES LLC.
| 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.