HEADWATERS, INC. (NPI# 1649547183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649547183 |
| Entity Type | Organization |
| Organization Name | HEADWATERS, INC. |
| Practice Address |
1441 E Timber Dr Rhinelander WI 54501-2887 |
| Mailing Address |
Po Box 618 Rhinelander WI 54501-0618 |
| Practice Telephone | 7153691337 |
| Practice Fax Number | 7153691793 |
| Mailing Telephone | 7153691337 |
| Mailing Fax Number | 7153691793 |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2011-11-29 |
| Authorized Official Name | MARY HARDTKE (DIRECTOR) |
| Authorized Official Telephone | 7153691337 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities | ||
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
| N | 347B00000X | Bus | Transportation Services | ||
| Y | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HEADWATERS, INC | 134 Pleasant St, Marblehead, MA 01945-2364 |
| Street Address |
1441 E TIMBER DR |
| City | RHINELANDER |
| State | WI |
| Zip Code | 54501-2887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134667884 | Gracies Place Inc. | Community/Behavioral Health | 1441 E Timber Dr, Rhinelander, WI 54501-2887 | 2017-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124513361 | Nathan Wigington | Dentist | 803 Lincoln Street, Rhinelander, WI 54501 | 2018-06-29 |
| 1659865582 | Wendy Jahsmann | Physical Therapy Assistant | 1970 Navajo Street, Rhinelander, WI 54501 | 2018-06-14 |
| 1699262055 | Marshfield Clinic Inc | Durable Medical Equipment & Medical Supplies | 2260 North Shore Drive, Rhinelander, WI 54501 | 2018-04-20 |
| 1467967489 | Harmony Counseling Services Dba Transitions Center | Counselor | 22 N Pelham Str., Rhinelander, WI 54501 | 2017-12-13 |
| 1316392046 | Horace Donn De Yampert | Physical Therapist | 528 Shepard Street, Rhinelander, WI 54501 | 2016-05-02 |
| 1588019582 | Oksana Smith | Physical Therapy Assistant | 1318 Eagle St, Rhinelander, WI 54501 | 2016-04-27 |
| 1639535115 | Rita Jean Semmerling | Counselor | 22 N. Pelham St., Rhinelander, WI 54501 | 2016-01-13 |
| 1891151809 | Jolie Dirrigle | Social Worker | 1020 Kabel Avenue, Rhinelander, WI 54501 | 2016-01-06 |
| 1861758260 | The Country Seed Inc. | Specialist | 210 E. Anderson Street, Rhinelander, WI 54501 | 2012-04-10 |
| 1952605446 | Adam Carlson | Physical Therapist | 7543 Woodboro Heights Rd, Rhinelander, WI 54501 | 2010-12-27 |
| Find all providers in zip 54501 | ||||
| Taxonomy Code | 385HR2060X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457983843 | Walker Family Daycare Inc | Respite Care | 1111 Industrial St, Reedsburg, WI 53959-2147 | 2020-02-04 |
| 1619527447 | Melissa Ann Damrell | Respite Care | 950 1st Ave, Cumberland, WI 54829-9550 | 2019-09-13 |
| 1831744689 | Adam Thomas Bever | Respite Care | 320 Mission Pl, Rice Lake, WI 54868-1923 | 2019-08-08 |
| 1083183016 | Umenia Marie White | Respite Care | 7726 W. Center Street, Apt 1, Milwaukee, WI 53222 | 2018-11-20 |
| 1164739934 | Carly Baker | Respite Care | 146 E Tilson St., West Salem, WI 54669-1213 | 2010-09-01 |
| 1922311786 | We Care Wisconsin LLC | Respite Care | 4236 N Teutonia Ave, Milwaukee, WI 53209-6734 | 2010-07-22 |
| 1588898225 | Patrick Edward Swope | Respite Care | 1232 Zblewski Dr, Plover, WI 54467-2366 | 2009-05-10 |
| 1730332321 | 4u Adult Day Service, LLC | Respite Care | 2311 Post Rd, Plover, WI 54467-2972 | 2008-10-28 |
| City | RHINELANDER |
| Zip Code | 54501 |
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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.