Shawano County Dept Of Human Services -lakeland Center Csp Svcs | |
504 Lakeland Rd Shawano WI 54166 | |
(715) 526-4700 | |
(715) 526-5542 |
Full Name | Shawano County Dept Of Human Services -lakeland Center Csp Svcs |
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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 |
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Shawano County Dept Of Human Services -lakeland Center Csp Svcs 504 Lakeland Rd Shawano WI 54166 Ph: (715) 526-4700 | Shawano County Dept Of Human Services -lakeland Center Csp Svcs 504 Lakeland Rd Shawano WI 54166 Ph: (715) 526-4700 |
NPI Number | 1558528729 |
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Provider Enumeration Date | 05/16/2008 |
Last Update Date | 01/23/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558528729 | NPI | - | NPPES |
43425800 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 1831 (Wisconsin) | Secondary |
251S00000X | Community/behavioral Health | 2242 (Wisconsin) | Primary |
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