WISCONSIN RECOVERY INSTITUTE
NPI 1053166942
Substance Abuse Rehabilitation Facility in Fond Du Lac, WI
About Wisconsin Recovery Institute NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WISCONSIN RECOVERY INSTITUTE (NPI 1053166942) is a healthcare organization registered as a substance abuse rehabilitation facility in Fond Du Lac, Wisconsin and active in the NPI registry since April 2024. The organization holds a CLIA Waiver certificate valid through April 25, 2028 and lists Jacob Edelstein, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 52D2303525
Wisconsin Recovery Institute LLC · Fond Du Lac, WIFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Wisconsin Recovery Institute's NPI number?
The NPI number for Wisconsin Recovery Institute is 1053166942. It was assigned to this organization in the NPPES registry on April 23, 2024.
Where is Wisconsin Recovery Institute located?
Wisconsin Recovery Institute is located at 1446 Lynn Ave, Fond Du Lac, WI 54937. The listed phone number is (920) 990-2104.
What is Wisconsin Recovery Institute's specialty?
The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
Does Wisconsin Recovery Institute hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 52D2303525) is associated with this NPI, valid through April 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Wisconsin Recovery Institute was last updated on April 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Wisconsin Recovery Institute · NPI 1053166942
Substance Abuse Rehabilitation Facility organization in Fond Du Lac, Wisconsin. Organization record, active in the CMS NPPES registry since April 23, 2024.
## Identity
- **NPI:** 1053166942 (Entity type: Organization)
- **Enumerated:** April 23, 2024
- **Primary specialty:** Substance Abuse Rehabilitation Facility · taxonomy 324500000X
- **Organization subpart:** No
- **Authorized official:** Jacob Edelstein, OWNER
## Practice location
- **Address:** 1446 LYNN AVE, Fond Du Lac, WI 54937-6900
- **Phone:** (920) 990-2104
## Record status
- **NPPES last updated:** April 23, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1053166942) · Data from the CMS NPPES public registry.