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NPI 1801092374

NPI 1801092374 : TAYLOR COUNTY : MEDFORD, WI

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General NPI Number Information
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    NPI Number           |    1801092374
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    Entity Type          |    Organization 
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    Legal Business Name  |    TAYLOR COUNTY 
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Dates
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    Enumeration Date     |    06/22/2007
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    Last Update Date     |    10/08/2008
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Provider Practice Location Address
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    Address Line         |    540 COLLEGE AVE 
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    City                 |    MEDFORD
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    State                |    WI
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    Zip                  |    54451
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    Country              |    US
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    Telephone            |    715-748-3332
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    Fax                  |    715-748-3342
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Provider Business Mailing Address
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    Address Line         |    540 COLLEGE AVE 
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    City                 |    MEDFORD
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    State                |    WI
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    Zip                  |    54451
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    Country              |    US
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    Telephone            |    715-748-3332
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    Fax                  |    715-748-3342
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     SUSAN M HADY 
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    Credential           |    
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    Telephone            |    715-748-3332
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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       |    
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    License Number State |    
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