Healthcare Provider Details

I. General information

NPI: 1659553618
Provider Name (Legal Business Name): ST CROIX COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 DORSET LN
NEW RICHMOND WI
54017-2452
US

IV. Provider business mailing address

1752 DORSET LN
NEW RICHMOND WI
54017-2452
US

V. Phone/Fax

Practice location:
  • Phone: 715-246-8263
  • Fax: 715-246-8367
Mailing address:
  • Phone: 715-246-8263
  • Fax: 715-246-8367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: ELLE KLASEN
Title or Position: INTERIM PUBLIC HEALTH OFFICER
Credential:
Phone: 715-246-8453