Healthcare Provider Details

I. General information

NPI: 1780804039
Provider Name (Legal Business Name): ST CROIX COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
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: 715-246-8365
  • Fax: 715-246-8298
Mailing address:
  • Phone: 715-246-8365
  • Fax: 715-246-8298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELLE KLASEN
Title or Position: HEALTH OFFICER -PUBLIC HEALTH COORD
Credential:
Phone: 715-246-8363