Healthcare Provider Details

I. General information

NPI: 1063658557
Provider Name (Legal Business Name): FAMILY & CHILDREN'S CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2009
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 W BROADWAY ST
WINONA MN
55987-5216
US

IV. Provider business mailing address

1707 MAIN ST
LA CROSSE WI
54601-4200
US

V. Phone/Fax

Practice location:
  • Phone: 507-454-7711
  • Fax: 507-452-0325
Mailing address:
  • Phone: 608-785-0001
  • Fax: 608-785-0002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ANN T MCDONALD
Title or Position: CFO
Credential:
Phone: 608-785-0001