Provider Demographics
NPI:1447496245
Name:ACCESS TO INDEPENDENCE, INC.
Entity type:Organization
Organization Name:ACCESS TO INDEPENDENCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DELORIS
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:TRUHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-242-8484
Mailing Address - Street 1:301 SOUTH LIVINGSTON STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-5401
Mailing Address - Country:US
Mailing Address - Phone:608-242-8484
Mailing Address - Fax:608-242-0383
Practice Address - Street 1:301 SOUTH LIVINGSTON STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-5401
Practice Address - Country:US
Practice Address - Phone:608-242-8484
Practice Address - Fax:608-242-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIATN:1155253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIATN1155Medicaid