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General NPI Number Information
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NPI Number | 1255891933
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Entity Type | Organization
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Legal Business Name | EAU CLAIRE COUNTY DEPARTMENT OF HUMAN SERVICES
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 03/20/2019
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Provider Practice Location Address
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Address Line | 721 OXFORD AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54703-5212
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Country | US
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Telephone | 715-839-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 721 OXFORD AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54703-5212
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FISCAL SERVICES MANAGER
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Name | VICKIE GARDNER
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Credential |
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Telephone | 715-839-2997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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