Healthcare Provider Details

I. General information

NPI: 1619835709
Provider Name (Legal Business Name): CHILEDA INSTITUTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3716 MORMON COULEE RD
LA CROSSE WI
54601-7363
US

IV. Provider business mailing address

1825 VICTORY ST
LA CROSSE WI
54601-7201
US

V. Phone/Fax

Practice location:
  • Phone: 608-782-6480
  • Fax:
Mailing address:
  • Phone: 608-782-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. DEREK CORTEZ
Title or Position: CEO
Credential:
Phone: 608-782-6480