Healthcare Provider Details

I. General information

NPI: 1518731173
Provider Name (Legal Business Name): KABBA INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W BROADWAY STE 2
MONONA WI
53713-3707
US

IV. Provider business mailing address

1955 W BROADWAY STE 102
MONONA WI
53713-3700
US

V. Phone/Fax

Practice location:
  • Phone: 608-291-5024
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: SARA ALLEE-JATTA
Title or Position: DIRECTOR
Credential: CSAC, ICS
Phone: 608-291-5024