Rusk County Csp | |
219 W 2nd St North Lady Smith WI 54848 | |
(715) 532-5940 | |
(715) 532-5947 |
Full Name | Rusk County Csp |
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Speciality | Community/behavioral Health |
Location | 219 W 2nd St North, Lady Smith, Wisconsin |
Authorized Official Name and Position | Pamela Olson (CLINICAL COORDINATOR) |
Authorized Official Contact | 7155325940 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Rusk County Csp 219 W 2nd St North Ladysmith WI 54848 Ph: (715) 532-5940 | Rusk County Csp 219 W 2nd St North Lady Smith WI 54848 Ph: (715) 532-5940 |
NPI Number | 1053586412 |
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Provider Enumeration Date | 04/28/2008 |
Last Update Date | 04/28/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053586412 | NPI | - | NPPES |
43429800 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (Wisconsin) | Primary |