Healthcare Provider Details

I. General information

NPI: 1114095395
Provider Name (Legal Business Name): CHIPPEWA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N BRIDGE ST ROOM 305
CHIPPEWA FALLS WI
54729-1845
US

IV. Provider business mailing address

711 N BRIDGE ST ROOM 305
CHIPPEWA FALLS WI
54729-1845
US

V. Phone/Fax

Practice location:
  • Phone: 715-726-7788
  • Fax: 715-726-7736
Mailing address:
  • Phone: 715-726-7788
  • Fax: 715-726-7736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. LARRY WINTER
Title or Position: DEPT OF HUMAN SERVICES DIRECTOR
Credential:
Phone: 715-726-7788