National Provider Identifier Database

HEADWATERS INC
Respite Care, Intellectual and/or Developmental Disabilities

A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.


Contact Information

HEADWATERS, INC.
1441 E TIMBER DR
RHINELANDER, WI54501-2887
Phone: 715-369-1337
Fax: 715-369-1793
Website:
Specialty Taxonomy Code
* Respite Care, Intellectual and/or Developmental Disabilities 385HR2060X
Bus 347B00000X
Day Training, Developmentally Disabled Services 251C00000X
Developmental Disabilities 261QD1600X
Early Intervention Provider Agency 252Y00000X

* Indicates primary specialty

NPI Profile & details for HEADWATERS, INC.

NPI Number 1649547183
Legal business name
LBN
HEADWATERS, INC.
Authorized official MARY HARDTKE - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 11/29/2011
Last updated 11/29/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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