Provider Demographics
NPI:1427481480
Name:MADISON COLLEGE
Entity type:Organization
Organization Name:MADISON COLLEGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DEAN OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GROTELUESCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:608-246-6556
Mailing Address - Street 1:1701 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-2599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1701 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-2599
Practice Address - Country:US
Practice Address - Phone:608-246-6556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131331-30313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility