Healthcare Provider Details

I. General information

NPI: 1265767966
Provider Name (Legal Business Name): UPLAND HILLS HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 W JEFFERSON ST
SPRING GREEN WI
53588-8005
US

IV. Provider business mailing address

800 COMPASSION WAY PO BOX 800
DODGEVILLE WI
53533-1956
US

V. Phone/Fax

Practice location:
  • Phone: 608-588-2600
  • Fax: 608-588-2644
Mailing address:
  • Phone: 608-930-8000
  • Fax: 608-930-7251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number37632-20
License Number StateWI

VIII. Authorized Official

Name: LISA SCHNEDLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 608-930-7200