Healthcare Provider Details

I. General information

NPI: 1093350563
Provider Name (Legal Business Name): THE HMONG INSTITUTE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2019
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4402 FEMRITE DR
MADISON WI
53716-4122
US

IV. Provider business mailing address

5310 ARAPAHOE LN
MADISON WI
53704-1002
US

V. Phone/Fax

Practice location:
  • Phone: 608-492-1213
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: PENG HER
Title or Position: CEO
Credential:
Phone: 608-628-3901