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General NPI Number Information
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NPI Number | 1295964435
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Entity Type | Organization
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Legal Business Name | POLK COUNTY-DEPT OF ADMINISTRATION
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 100 POLK COUNTY PLZ STE 1801
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City | BALSAM LAKE
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State | WI
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Zip | 54810-9071
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Country | US
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Telephone | 715-485-8500
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Fax | 715-485-8500
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Provider Business Mailing Address
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Address Line | 100 POLK COUNTY PLZ STE 180
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City | BALSAM LAKE
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State | WI
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Zip | 54810-9071
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Country | US
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Telephone | 715-485-8500
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Fax | 715-485-8500
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. GRETCHEN SAMPSON
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Credential |
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Telephone | 715-485-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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