| Ho-chunk Community Health Care Nursing Program | |
|
N6520 Lumberjack Guy Rd Black River Falls WI 54615-5405 | |
| (715) 284-9851 | |
| (715) 284-5051 |
| Full Name | Ho-chunk Community Health Care Nursing Program |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | N6520 Lumberjack Guy Rd, Black River Falls, Wisconsin |
| Authorized Official Name and Position | Liz M Lund (PROVIDER NETWORK MANAGER) |
| Authorized Official Contact | 7152849851 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ho-chunk Community Health Care Nursing Program N6520 Lumberjack Guy Rd Black River Falls WI 54615-5405 Ph: (715) 284-9851 | Ho-chunk Community Health Care Nursing Program N6520 Lumberjack Guy Rd Black River Falls WI 54615-5405 Ph: (715) 284-9851 |
| NPI Number | 1922263656 |
|---|---|
| Provider Enumeration Date | 07/22/2008 |
| Last Update Date | 03/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922263656 | NPI | - | NPPES |
| 52D2018007 | Other | WI | CLIA |
| 44015100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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