ALICIA'S PLACE — NPI 1669260808 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in CRANDON, WI)

CMS-1500 Box 24J / 33a • NPI

1669260808

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QA0600X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

605 S FOREST AVE, CRANDON, WI, 54520-1703

✓ 9-Digit EDI 837 ZIP+4 (54520-1703)

Practice Phone & Referral Fax

(715) 902-0848

Fax: (262) 661-2206

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1669260808 (ALICIA'S PLACE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1669260808` (NPI-2 Organization / Facility)
Provider / Legal Name	ALICIA'S PLACE
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QA0600X` (Clinic/Center, Adult Day Care)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	605 S FOREST AVE, CRANDON, WI, 54520-1703
Practice Telephone / Fax	Tel: (715) 902-0848 \| Fax: (262) 661-2206
Administrative Mailing Address	501 E GRANT ST, CRANDON, WI, 54520-1673
Enumeration & Last Sync	Enumerated: 2025-04-28 \| CMS Record Updated: 2025-04-28
Authorized Official	KAYLA VAN CLEVE (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

605 S FOREST AVE, CRANDON, WI, 54520-1703

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Plain-English Taxonomy & CMS Crosswalk (261QA0600X)

What Does Taxonomy Code 261QA0600X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QA0600X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ALICIA'S PLACE)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`251J00000X` — Nursing Care Plain English: Licensed Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF)	State: N/A \| License: `Verified` \| Primary: Secondary
`261QA0600X` — Clinic/Center, Adult Day Care Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)
`385H00000X` — Respite Care Plain English: Licensed & Credentialed Respite Care	State: N/A \| License: `Verified` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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ALICIA'S PLACE (NPI #1669260808)