| Rock County Human Services Department Beloit Community Support Program | |
|
64 Eclipse Ctr Beloit WI 53511-3550 | |
| (608) 363-6200 | |
| Not Available |
| Full Name | Rock County Human Services Department Beloit Community Support Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 64 Eclipse Ctr, Beloit, Wisconsin |
| Authorized Official Name and Position | Michael B Jones (ADMINISTRATIVE SERVICES MANAGER) |
| Authorized Official Contact | 6087575204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rock County Human Services Department Beloit Community Support Program 64 Eclipse Ctr Beloit WI 53511-3550 Ph: (608) 363-6200 | Rock County Human Services Department Beloit Community Support Program 64 Eclipse Ctr Beloit WI 53511-3550 Ph: (608) 363-6200 |
| NPI Number | 1417120882 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417120882 | NPI | - | NPPES |
| 43420300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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