NPI: 1437433562 · GREEN BAY, WI 54301 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI assigned 10/07/2011
| Authorized Official | BLONDHEIM, KERRY (VICE PRESIDENT OF ADMINISTRATION) |
| NPI Enumeration Date | 10/07/2011 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,098 | $438K |
| 2019 | 2,729 | $413K |
| 2020 | 1,336 | $97K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2017 | Habilitation, residential, waiver; 15 minutes | 1,704 | 646 | $465K |
| S5135 | Companion care, adult (e.g., iadl/adl); per 15 minutes | 858 | 202 | $200K |
| S5150 | Unskilled respite care, not hospice; per 15 minutes | 482 | 99 | $116K |
| S5125 | Attendant care services; per 15 minutes | 332 | 51 | $70K |
| S0215 | Non-emergency transportation; mileage, per mile | 2,434 | 833 | $52K |
| S5110 | Home care training, family; per 15 minutes | 353 | 24 | $45K |