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General NPI Number Information
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NPI Number | 1811274871
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Entity Type | Organization
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Legal Business Name | UPLAND POINT CORPORATION
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 1345 STATE ROAD 23
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City | MINERAL POINT
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State | WI
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Zip | 53565-9299
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Country | US
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Telephone | 608-341-8301
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Fax | 608-987-3700
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Provider Business Mailing Address
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Address Line | PO BOX 110
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City | MINERAL POINT
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State | WI
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Zip | 53565-0110
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Country | US
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Telephone | 608-341-8301
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Fax | 608-987-3700
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BERNARD PAUL BOBER
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Credential |
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Telephone | 608-341-8301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 0010696
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License Number State | WI
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