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Kelly Lee Dittberner
Home Health Agency in Portage, Wisconsin
NPI 1376710251

Kelly Lee Dittberner is a Home Health Agency based in Lodi, WI. Kelly Lee Dittberner practices in Portage, WI. The NPI Number for Kelly Lee Dittberner is 1376710251 and holds a License No. (Wisconsin).

The current practice location address for Kelly Lee Dittberner is 215 Northridge Dr, Portage, WI and can be reached out via phone at 608-516-9337 and via fax at 608-745-0333.

Location: 215 Northridge Dr, Portage, WI, 53555-9329
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376710251
Provider Name
Kelly Lee Dittberner
Credential
Provider Entity Type
Individual
Gender
Female
Address
215 Northridge Dr, Portage, WI, 53555-9329
Phone Number
608-516-9337
Fax Number
608-745-0333
Provider Enumeration Date
05/10/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
215 Northridge Dr
City
Portage
State
Wisconsin
Zip
53901-9294
Phone Number
608-516-9337
Fax Number
608-745-0333
person
Provider Business Mailing Address Details
Address
215 Northridge Dr
City
Portage
State
Wisconsin
Zip
53901-9294
Phone Number
608-516-9337
Fax Number
608-745-0333
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
251E00000X
License No.
()
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
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