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General NPI Number Information
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NPI Number | 1215801154
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Entity Type | Organization
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Legal Business Name | LAC COURTE OREILLES COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 9940 N COUNTY HWY K
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City | HAYWARD
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State | WI
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Zip | 54843-4277
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Country | US
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Telephone | 715-638-5100
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Fax | 715-634-6107
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Provider Business Mailing Address
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Address Line | 9940 N COUNTY HWY K
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City | HAYWARD
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State | WI
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Zip | 54843-4277
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Country | US
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Telephone | 715-638-5100
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Fax | 715-634-6107
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Authorized Official
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Title or Position | BILLING MANANGER
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Name | RAE E BAKER
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Credential |
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Telephone | 715-638-5169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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