Healthcare Provider Details

I. General information

NPI: 1891987657
Provider Name (Legal Business Name): LA CROSSE COUNTY AGING UNIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 4TH ST N
LA CROSSE WI
54601-3227
US

IV. Provider business mailing address

400 4TH ST N
LA CROSSE WI
54601-3227
US

V. Phone/Fax

Practice location:
  • Phone: 608-785-6148
  • Fax:
Mailing address:
  • Phone: 608-785-6148
  • Fax: 608-785-6135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MS. NOREEN KUROSKI
Title or Position: DIRECTOR
Credential:
Phone: 608-785-6148