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General NPI Number Information
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NPI Number | 1518896539
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Entity Type | Organization
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Legal Business Name | FOND DU LAC COUNTY HUMAN SERVICE GROUP HOMES
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 79 E 9TH ST
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City | FOND DU LAC
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State | WI
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Zip | 54935-5056
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Country | US
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Telephone | 920-929-3482
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Fax |
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Provider Business Mailing Address
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Address Line | 400 UNIVERSITY DR STE A1
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City | FOND DU LAC
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State | WI
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Zip | 54935-2997
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Country | US
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Telephone | 920-929-3446
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Fax | 920-929-3446
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Authorized Official
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Title or Position | BUSINESS OPERATION DIVISION MANAGER
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Name | MICHELLE PAUL
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Credential |
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Telephone | 920-929-3446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SL0600X
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Taxonomy Name | Long-Term Care Clinical Nurse Specialist
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License Number |
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License Number State |
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