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General NPI Number Information
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NPI Number | 1790901627
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Entity Type | Organization
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Legal Business Name | COUNTY OF IRON
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 300 TACONITE ST STE 201
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City | HURLEY
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State | WI
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Zip | 54534-1546
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Country | US
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Telephone | 715-561-3636
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Fax | 715-561-2128
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Provider Business Mailing Address
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Address Line | 300 TACONITE ST STE 201
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City | HURLEY
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State | WI
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Zip | 54534-1546
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Country | US
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Telephone | 715-561-3636
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Fax | 715-561-2128
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Authorized Official
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Title or Position | DIRECTOR
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Name | CAROLYN KOLSON-JANOV
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Credential |
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Telephone | 715-561-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2347
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License Number State | WI
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