Healthcare Provider Details

I. General information

NPI: 1982004578
Provider Name (Legal Business Name): MADISON AREA REHABILITATION CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 POST RD
MADISON WI
53713-3260
US

IV. Provider business mailing address

901 POST RD
MADISON WI
53713-3260
US

V. Phone/Fax

Practice location:
  • Phone: 608-223-9110
  • Fax: 608-223-9112
Mailing address:
  • Phone: 608-223-9110
  • Fax: 608-223-9112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RUSSELL KING
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 608-223-9110