National Provider Identifier Database

ENDEAVOR THERAPY LLC
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)


Contact Information

ENDEAVOR THERAPY LLC
11649 N PORT WASHINGTON RD
STE 109
MEQUON, WI53092-3460
Phone: 262-241-8892
Fax: 262-241-8894
Website:
Specialty Taxonomy Code
* Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X

* Indicates primary specialty

NPI Profile & details for ENDEAVOR THERAPY LLC

NPI Number 1699777417
Legal business name
LBN
ENDEAVOR THERAPY LLC
Authorized official KAREN BLOCK - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 08/11/2005
Last updated 06/11/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • WI Medicaid: 40076000

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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