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General NPI Number Information
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NPI Number | 1831859529
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Entity Type | Organization
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Legal Business Name | MENOMONIE AREA SENIOR CENTER
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 1412 6TH STREET EAST
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City | MENOMONIE
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State | WI
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Zip | 54751
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Country | US
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Telephone | 715-235-0954
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Fax | 715-235-1346
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Provider Business Mailing Address
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Address Line | 1412 6TH STREET EAST
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City | MENOMONIE
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State | WI
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Zip | 54751
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Country | US
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Telephone | 715-235-0954
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Fax | 715-235-1364
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR
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Name | SHARI LEE HOMSTAD
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Credential |
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Telephone | 715-235-0954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | NULL
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