Fond Du Lac Co Dcp Ccs Program | |
459 E 1st St Fond Du Lac WI 54935-4505 | |
(920) 929-3500 | |
Not Available |
Full Name | Fond Du Lac Co Dcp Ccs Program |
---|---|
Speciality | Community/behavioral Health |
Location | 459 E 1st St, Fond Du Lac, Wisconsin |
Authorized Official Name and Position | Mary Ellen Mcmeen (DIRECTOR-MENTAL HEALTH & AODA) |
Authorized Official Contact | 9209293500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Fond Du Lac Co Dcp Ccs Program 459 E 1st St Fond Du Lac WI 54935-4505 Ph: (920) 929-3500 | Fond Du Lac Co Dcp Ccs Program 459 E 1st St Fond Du Lac WI 54935-4505 Ph: (920) 929-3500 |
NPI Number | 1255454047 |
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Provider Enumeration Date | 04/09/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255454047 | NPI | - | NPPES |
41763000 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Fond Du Lac County Department Of Community Programs Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 459 E 1st St, Fond Du Lac, WI 54935 Phone: 920-929-3500 Fax: 920-929-3129 | |
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