Healthcare Provider Details

I. General information

NPI: 1083888788
Provider Name (Legal Business Name): ST CROIX COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
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: 715-246-8330
  • Fax: 715-246-8367
Mailing address:
  • Phone: 715-246-8263
  • Fax: 715-246-8367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: FAY STRENKE
Title or Position: FISCAL MANAGER
Credential:
Phone: 715-246-8217