Healthcare Provider Details

I. General information

NPI: 1568990406
Provider Name (Legal Business Name): WINNEBAGO CO DEPT OF HUMAN SVC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 08/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 WASHINGTON AVE
OSHKOSH WI
54901-5030
US

IV. Provider business mailing address

220 WASHINGTON AVE
OSHKOSH WI
54901-5030
US

V. Phone/Fax

Practice location:
  • Phone: 920-236-4739
  • Fax: 920-236-1157
Mailing address:
  • Phone: 920-236-4739
  • Fax: 920-236-1157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LOUIS W TOPEL
Title or Position: HUMAN SERVICES DIRECTOR
Credential: PSYD
Phone: 920-236-4739