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General NPI Number Information
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NPI Number | 1952844334
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Entity Type | Organization
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Legal Business Name | INCLUSA INC
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 3349 CHURCH ST STE 1
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City | STEVENS POINT
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State | WI
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Zip | 54481-5314
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Country | US
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Telephone | 608-785-5709
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Fax |
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Provider Business Mailing Address
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Address Line | 3349 CHURCH ST STE 1
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City | STEVENS POINT
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State | WI
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Zip | 54481-5314
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JASON TAYLOR
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Credential |
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Telephone | 715-204-1810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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