Provider Demographics
NPI:1962650721
Name:LORI KNAPP INC.
Entity type:Organization
Organization Name:LORI KNAPP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEDGEWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-326-5536
Mailing Address - Street 1:1100 S MARQUETTE RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU CHIEN
Mailing Address - State:WI
Mailing Address - Zip Code:53821-2414
Mailing Address - Country:US
Mailing Address - Phone:608-326-5536
Mailing Address - Fax:608-326-4255
Practice Address - Street 1:1100 S MARQUETTE RD
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU CHIEN
Practice Address - State:WI
Practice Address - Zip Code:53821-2414
Practice Address - Country:US
Practice Address - Phone:608-326-5536
Practice Address - Fax:608-326-4255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities