Provider Demographics
NPI:1053401869
Name:CATALYST, INC
Entity type:Organization
Organization Name:CATALYST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILPOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:608-238-8119
Mailing Address - Street 1:222 N MIDVALE BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-5072
Mailing Address - Country:US
Mailing Address - Phone:608-238-8119
Mailing Address - Fax:
Practice Address - Street 1:222 N MIDVALE BLVD STE 8
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-5072
Practice Address - Country:US
Practice Address - Phone:608-238-8119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI316251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43107600Medicaid
WI316OtherSTATE LICENSE
WI43107600Medicaid