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General NPI Number Information
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NPI Number | 1366008609
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Entity Type | Organization
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Legal Business Name | THE SENSORY CLUB, INC.
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | W238N1690 ROCKWOOD DR STE 500
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City | WAUKESHA
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State | WI
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Zip | 53188-2484
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Country | US
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Telephone | 262-269-5200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 180512
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City | DELAFIELD
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State | WI
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Zip | 53018-0512
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Country | US
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Telephone | 262-269-5200
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF COMMUNITY ENGAGEMENT
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Name | STEPHANIE BARTELT
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Credential |
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Telephone | 262-269-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number |
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License Number State |
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