Healthcare Provider Details

I. General information

NPI: 1144999780
Provider Name (Legal Business Name): WREN RIDGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

889 HIGHLAND PARK RD
NEENAH WI
54956-7003
US

IV. Provider business mailing address

889 HIGHLAND PARK RD
NEENAH WI
54956-7003
US

V. Phone/Fax

Practice location:
  • Phone: 651-278-0314
  • Fax:
Mailing address:
  • Phone: 651-278-0314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SABRINA CANALES
Title or Position: OWNER
Credential:
Phone: 651-278-0314