Healthcare Provider Details

I. General information

NPI: 1295912475
Provider Name (Legal Business Name): THE HUMAN SERVICE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E TIMBER DR
RHINELANDER WI
54501-2859
US

IV. Provider business mailing address

705 E TIMBER DR P.O. BOX 897
RHINELANDER WI
54501-2859
US

V. Phone/Fax

Practice location:
  • Phone: 715-369-2215
  • Fax: 715-369-4577
Mailing address:
  • Phone: 715-369-2215
  • Fax: 715-369-4577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ANN M. CLEEREMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 715-369-2215