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926 South 8th Street Manitowoc WI 54221-1177 | |
| (920) 683-4230 | |
| (920) 683-4908 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 926 South 8th Street, Manitowoc, Wisconsin |
| Authorized Official Name and Position | Lmf M Lori M. Fure (DIRECTOR) |
| Authorized Official Contact | 9206834981 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1177 926 South 8th Street Manitowoc WI 54221-1177 Ph: (920) 683-4230 | 926 South 8th Street Manitowoc WI 54221-1177 Ph: (920) 683-4230 |
| NPI Number | 1477727345 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 01/27/2025 |
| Certification Date | 01/27/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477727345 | NPI | - | NPPES |
| 41763300 | Medicaid | WI | |
| 42139400 | Medicaid | WI | |
| 32977571 | Medicaid | WI | |
| 43079700 | Medicaid | WI | |
| 43106400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1555 (Wisconsin) | Primary |
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Manitowoc Co Human Services Dept. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 926 S 8th St, Manitowoc, WI 54220 Phone: 920-683-4230 Fax: 920-683-4908 | |
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