Healthcare Provider Details

I. General information

NPI: 1548687486
Provider Name (Legal Business Name): POSITIVE ALTERNATIVES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 TERRILL RD
MENOMONIE WI
54751-3853
US

IV. Provider business mailing address

603 TERRILL RD
MENOMONIE WI
54751-3853
US

V. Phone/Fax

Practice location:
  • Phone: 715-235-9552
  • Fax: 715-235-1075
Mailing address:
  • Phone: 715-235-9552
  • Fax: 715-235-1075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number6327127
License Number StateWI

VIII. Authorized Official

Name: KELLI KAMHOLZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 715-235-9552