1801069406 NPI number — FLORENCE COUNTY HUMAN SERVICES DEPARTMENT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801069406 NPI number — FLORENCE COUNTY HUMAN SERVICES DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLORENCE COUNTY HUMAN SERVICES DEPARTMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801069406
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 LAKE AVENUE
Provider Second Line Business Mailing Address:
PO BOX 170 COURTHOUSE LOWERLEVEL
Provider Business Mailing Address City Name:
FLORENCE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54121-0170
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-528-3296
Provider Business Mailing Address Fax Number:
715-528-3341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 LAKE AVENUE
Provider Second Line Business Practice Location Address:
COURTHOUSE LOWERLEVEL
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54121-0170
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-528-3296
Provider Business Practice Location Address Fax Number:
715-528-3341
Provider Enumeration Date:
04/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
STEBER
Authorized Official First Name:
JEN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
715-528-3470

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 222Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 43079300 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43114900 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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