| Lac Courte Oreilles Day Treatment Program | |
|
13380 W Trepania Rd Hayward WI 54843-2186 | |
| (715) 638-5100 | |
| (715) 634-6107 |
| Full Name | Lac Courte Oreilles Day Treatment Program |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 13380 W Trepania Rd, Hayward, Wisconsin |
| Authorized Official Name and Position | James Driving Hawk (HEALTH DIRECTOR) |
| Authorized Official Contact | 7156385100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lac Courte Oreilles Day Treatment Program 13380 W Trepania Rd Hayward WI 54843-2186 Ph: (715) 638-5100 | Lac Courte Oreilles Day Treatment Program 13380 W Trepania Rd Hayward WI 54843-2186 Ph: (715) 638-5100 |
| NPI Number | 1275707010 |
|---|---|
| Provider Enumeration Date | 04/14/2008 |
| Last Update Date | 04/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275707010 | NPI | - | NPPES |
| 42135921 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 1486 (Wisconsin) | Primary |
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