Healthcare Provider Details

I. General information

NPI: 1043487697
Provider Name (Legal Business Name): TELLURIAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 MONONA DR STE 200
MONONA WI
53716-3561
US

IV. Provider business mailing address

5900 MONONA DR STE 200
MONONA WI
53716-3561
US

V. Phone/Fax

Practice location:
  • Phone: 608-223-3323
  • Fax:
Mailing address:
  • Phone: 608-222-7311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1904
License Number StateWI

VIII. Authorized Official

Name: ERICA L MUELLER
Title or Position: QA
Credential:
Phone: 914-316-6601