Provider Demographics
| NPI: | 1144980756 |
|---|---|
| Name: | ARIDAN LLC |
| Entity type: | Organization |
| Organization Name: | ARIDAN LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | MEMBER |
| Authorized Official - Prefix: | MS |
| Authorized Official - First Name: | AREANNA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BENNETT |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 906-250-0956 |
| Mailing Address - Street 1: | 2032 DREAMFIELD LN |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MENASHA |
| Mailing Address - State: | WI |
| Mailing Address - Zip Code: | 54952-9478 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 906-250-0956 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2032 DREAMFIELD LN |
| Practice Address - Street 2: | |
| Practice Address - City: | MENASHA |
| Practice Address - State: | WI |
| Practice Address - Zip Code: | 54952-9478 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 906-250-0956 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2021-12-22 |
| Last Update Date: | 2022-07-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 252Y00000X | Agencies | Early Intervention Provider Agency | |
| No | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
| No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
| No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 385H00000X | Respite Care Facility | Respite Care | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 251E00000X | Agencies | Home Health | |
| No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child |
| No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |
| No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |
