| Shawano County Dept Of Human Services-lakeland Center Case Mgmt Svcs | |
|
504 Lakeland Rd Shawano WI 54166-3836 | |
| (715) 526-4700 | |
| (715) 526-5542 |
| Full Name | Shawano County Dept Of Human Services-lakeland Center Case Mgmt Svcs |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 504 Lakeland Rd, Shawano, Wisconsin |
| Authorized Official Name and Position | Richard Kane (DIRECTOR) |
| Authorized Official Contact | 7155264700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawano County Dept Of Human Services-lakeland Center Case Mgmt Svcs 504 Lakeland Rd Shawano WI 54166-3836 Ph: (715) 526-4700 | Shawano County Dept Of Human Services-lakeland Center Case Mgmt Svcs 504 Lakeland Rd Shawano WI 54166-3836 Ph: (715) 526-4700 |
| NPI Number | 1336307008 |
|---|---|
| Provider Enumeration Date | 05/29/2008 |
| Last Update Date | 01/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336307008 | NPI | - | NPPES |
| 43075600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1831 (Wisconsin) | Primary |
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