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General NPI Number Information
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NPI Number | 1134037732
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Entity Type | Organization
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Legal Business Name | IGNITE THERAPEUTIC SERVICES, S.C.
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 1021 W NATIONAL AVE
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City | MILWAUKEE
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State | WI
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Zip | 53204-1347
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Country | US
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Telephone | 920-393-8320
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Fax |
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Provider Business Mailing Address
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Address Line | 14027 LYNCH DR
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City | ROGERS
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State | MN
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Zip | 55374-5828
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Country | US
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Telephone | 763-228-4344
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABBY HANSEN
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Credential | SLP
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Telephone | 920-393-8320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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