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NPI 1992971089

NPI 1992971089 : FOREST COUNTY DEPARTMENT OF SOCIAL SERVICES : CRANDON, WI

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General NPI Number Information
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    NPI Number           |    1992971089
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    Entity Type          |    Organization 
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    Legal Business Name  |    FOREST COUNTY DEPARTMENT OF SOCIAL SERVICES 
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Dates
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    Enumeration Date     |    05/08/2008
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    Last Update Date     |    05/08/2008
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Provider Practice Location Address
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    Address Line         |    200 E MADISON ST 
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    City                 |    CRANDON
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    State                |    WI
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    Zip                  |    54520-1415
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    Country              |    US
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    Telephone            |    715-478-3351
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    Fax                  |    715-478-2847
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Provider Business Mailing Address
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    Address Line         |    200 E MADISON ST 
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    City                 |    CRANDON
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    State                |    WI
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    Zip                  |    54520-1415
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    Country              |    US
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    Telephone            |    715-478-3351
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    Fax                  |    715-478-2847
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |    MR. CHARLES  SEKEL 
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    Credential           |    
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    Telephone            |    715-478-3351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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    License Number       |    
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    License Number State |    
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