Healthcare Provider Details

I. General information

NPI: 1518417286
Provider Name (Legal Business Name): COUNTY OF DUNN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 US HIGHWAY 12 E STE 160
MENOMONIE WI
54751-3044
US

IV. Provider business mailing address

3001 US HIGHWAY 12 E STE 225
MENOMONIE WI
54751-3045
US

V. Phone/Fax

Practice location:
  • Phone: 715-232-1116
  • Fax: 715-232-5987
Mailing address:
  • Phone: 715-232-1116
  • Fax: 715-232-5987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1287
License Number StateWI

VIII. Authorized Official

Name: JANE HANSEN
Title or Position: ACCOUNTING MANAGER
Credential:
Phone: 715-231-4586