Memorial Medical Center Inc, NPI 1801005210
Psychiatric Hospital Unit in Ashland, WI, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1801005210
NPI Entity Type Organization
Provider Name Memorial Medical Center Inc
Subpart of Organization Memorial Medical Center Inc
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 1615 Maple Ln, Ashland, WI, US
Provider Mailing Address 1615 Maple Ln, Ashland, WI, US, 548063610
Is Sole Proprietor? No
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Organization Official

Official Name MR. Jason T Douglas
Official Position PRESIDENT
Phone 715-685-5512

Primary Taxonomy

Taxonomy Code

273R00000X

Taxonomy Name Psychiatric Hospital Unit
Classification

Psychiatric Unit

Group

Hospital Units

License No. 275
License State WI
Description In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning.

Business Address

Memorial Medical Center Inc
1615 Maple Ln

Ashland, WI, US

Phone: 715-685-5500
Fax: 715-685-5118

Mailing Address

Memorial Medical Center Inc
1615 Maple Ln
Ashland, WI, US
ZIP 548063610
Phone: 715-685-5500
Fax: 715-685-5118

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
11019500 WI MEDICAID 05
36585ME MN BCBS PROF COMPONENT 01
3901638 WI MEDICA PROF COMPONENT 01
0160HME MN BLUE CROSS BLUE SHIELD 01
5025472 WI MEDICA 01
0160JME MN BLUE CROSS BLUE SHIELD 01
11019526 WI MEDICAID 05
01022385 WI PREFERRED ONE 01
11019521 WI MEDICAID 05

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NPI Name Taxonomy Address

1205582921

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MRS. APNP, PMHNP-BC Tilly Burroughs

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Shong Chang

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Organization

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1043862386

LCSW, SAC-IT Alexandra Duvall

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D-PT Rachel Ann Lohrengel

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LPC Rebecca A Richards

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1932468576

DR. D.O. Meredith Caroline Schaffner

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Rebecca Fafard

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Fort Healthcare, Inc.

Organization

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Fort Atkinson, WI

1447304340

Fort Healthcare, Inc.

Organization

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Fort Healthcare Inc

Organization

Counselor

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MRS. LPC Holly L Doughty

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Organization

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Organization

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500 Mcmillen St

Fort Atkinson, WI

1063566966

Fort Healthcare, Inc

Organization

Home Health Agency

611 Sherman Ave E

Fort Atkinson, WI

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