Healthcare Provider Details

I. General information

NPI: 1801069406
Provider Name (Legal Business Name): FLORENCE COUNTY HUMAN SERVICES DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 LAKE AVENUE COURTHOUSE LOWERLEVEL
FLORENCE WI
54121-0170
US

IV. Provider business mailing address

501 LAKE AVENUE PO BOX 170 COURTHOUSE LOWERLEVEL
FLORENCE WI
54121-0170
US

V. Phone/Fax

Practice location:
  • Phone: 715-528-3296
  • Fax: 715-528-3341
Mailing address:
  • Phone: 715-528-3296
  • Fax: 715-528-3341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name: JEN STEBER
Title or Position: DIRECTOR
Credential:
Phone: 715-528-3470