WILLOWGLEN ACADEMY, INC. (NPI# 1881745776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881745776 |
| Entity Type | Organization |
| Organization Name | WILLOWGLEN ACADEMY, INC. |
| Practice Address |
3903 W Lisbon Ave Milwaukee WI 53208-1835 |
| Mailing Address |
1744 N Farwell Ave Milwaukee WI 53202-1806 |
| Practice Telephone | 4143422060 |
| Practice Fax Number | 4143423663 |
| Mailing Telephone | 4142254460 |
| Mailing Fax Number | 4142254469 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. LEONARD F DZIUBLA (PRESIDENT & CEO) |
| Authorized Official Telephone | 4142254460 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | 2366 | WI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43003300 | 05 | |
| WI | STATE LICENSE | 2366 | 01 |
| Street Address |
3903 W LISBON AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53208-1835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508065582 | Doug Ryan Pulvermacher | Counselor | 3903 W Lisbon Ave, Milwaukee, WI 53208 | 2007-07-11 |
| 1073719498 | Lisa Kay Schon | Counselor | 3903 W Lisbon Ave, Milwaukee, WI 53208 | 2007-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831662535 | Mary Ehrgood | Marriage & Family Therapist | Aurora Family Service, 3200 W Highland Blvd, Milwaukee, WI 53208 | 2019-01-04 |
| 1265976989 | Redeeming Hearts Home Care Agency, LLC | Home Health | 3223 W Lloyd St, Milwaukee, WI 53208 | 2016-12-14 |
| 1205379500 | Benjamin Michael Bleck-owens | Counselor | 5508 W. Vliet Street, Milwaukee, WI 53208 | 2016-11-18 |
| 1730552662 | John Bosnjak | Pharmacist | 3727 W. Wisconsin Ave., Milwaukee, WI 53208 | 2015-10-30 |
| 1588074991 | Quad/med, LLC | Clinic/Center | 1301 West Canal Street, Milwaukee, WI 53208 | 2014-05-07 |
| 1629407226 | Dhanya Jayadevan Nair | Marriage & Family Therapist | 3200 W. Highland Blvd., Milwaukee, WI 53208 | 2013-11-04 |
| 1619215704 | Nurturing Concepts LLC | In Home Supportive Care | 5722 W North Ave, Milwaukee, WI 53208 | 2013-01-23 |
| 1831447986 | Amy Schuldt | Registered Nurse | 3727 W. Wisconsin Aveune, Milwaukee, WI 53208 | 2012-08-21 |
| 1144588922 | Grassroots Empowerment Project Inc | Community Health Worker | 3732 W Wisconsin Ave, Milwaukee, WI 53208 | 2012-04-30 |
| 1245468180 | Elizabeth Adams | Registered Nurse | 1917 N 34 Th St, Milwaukee, WI 53208 | 2009-06-30 |
| Find all providers in zip 53208 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902386055 | Islands of Brilliance | Day Training, Developmentally Disabled Services | 415 E Menomonee St, Milwaukee, WI 53202-6117 | 2018-08-17 |
| 1790275378 | United Communities Adult Daycare Service Inc | Day Training, Developmentally Disabled Services | 5330 W Lisbon Ave, Milwaukee, WI 53210-2751 | 2018-05-18 |
| 1437694338 | Bekus Adult Day Program LLC | Day Training, Developmentally Disabled Services | 4425 N 63rd St, Milwaukee, WI 53218-5548 | 2016-12-31 |
| 1992081954 | Nrs Services, LLC | Day Training, Developmentally Disabled Services | 9401 W Beloit Rd Ste 416, Milwaukee, WI 53227-4357 | 2011-10-22 |
| 1033352760 | Mount Castle Corporation | Day Training, Developmentally Disabled Services | 3808 W Elm St, Milwaukee, WI 53209-3031 | 2009-04-10 |
| 1407494081 | Adult Day Services of Wisconsin LLC | Day Training, Developmentally Disabled Services | 206 E Lincoln Ave, Milwaukee, WI 53207-1544 | 2019-12-14 |
| 1528497799 | Hope Housing of Shawano County and Wisconsin-usa | Day Training, Developmentally Disabled Services | 2153 N 36th St, Milwaukee, WI 53208-1406 | 2013-11-07 |
| 1922395508 | Banner Day Center | Day Training, Developmentally Disabled Services | 3801 N 88th St, Milwaukee, WI 53222-2706 | 2011-07-05 |
| 1194057026 | Howard Jansen Day Treatment | Day Training, Developmentally Disabled Services | 5151 W Silver Spring Dr, Milwaukee, WI 53218-3300 | 2010-02-03 |
| 1780822262 | Bell Therapy, Inc | Day Training, Developmentally Disabled Services | 6414 W Fond Du Lac Ave, Milwaukee, WI 53218-4917 | 2009-01-22 |
| Find all providers in MILWAUKEE | ||||
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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.