=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841991957
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRUE BELIEVERS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2023
-----------------------------------------------------
Last Update Date | 03/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2976 TRIVERTON PIKE DR STE 206
-----------------------------------------------------
City | FITCHBURG
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53711-5840
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-826-7448
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8383 GREENWAY BLVD STE 600
-----------------------------------------------------
City | MIDDLETON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53562-4659
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-826-7448
-----------------------------------------------------
Fax | 608-465-4021
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANGELA REED
-----------------------------------------------------
Credential | C
-----------------------------------------------------
Telephone | 608-444-1717
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------