ENDEAVOR THERAPY LLC; NPI #1699777417

Contact Information

ENDEAVOR THERAPY LLC

11649 N PORT WASHINGTON RD
STE 109
MEQUON, WI 53092-3460

Phone: 262-241-8892
Fax: 262-241-8894
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X	B4[14]	Comprehensive Outpatient Rehabilitation Facility

Indicates primary specialty

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NPI Profile & details for ENDEAVOR THERAPY LLC

NPI Number 1699777417

LBN Legal business name ENDEAVOR THERAPY LLC

Authorized official KAREN BLOCK - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/11/2005

Last updated 06/11/2010 - About 16 years ago

Identifiers

Medicaid

40076000

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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