Provider Demographics
NPI:1275421604
Name:GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN
Entity type:Organization
Organization Name:GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MISSION
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-246-3140
Mailing Address - Street 1:1302 MENDOTA ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-1059
Mailing Address - Country:US
Mailing Address - Phone:608-246-3140
Mailing Address - Fax:
Practice Address - Street 1:1302 MENDOTA ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-1059
Practice Address - Country:US
Practice Address - Phone:608-246-3140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services