LAC COURTE OREILLES GOVERNING BOARD NPI 1982813390

NPI Information

NPI: 1982813390
Provider Name: LAC COURTE OREILLES GOVERNING BOARD

Doing Business As: LAC COURTE OREILLES COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
13380 W TREPANIA RD
HAYWARD, WI
ZIP 54843
Phone: (715) 638-5100
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LAC COURTE OREILLES GOVERNING BOARD is a mental health (including community mental health center) clinic center in Hayward, WI. LAC COURTE OREILLES GOVERNING BOARD NPI is 1982813390. The provider is registered as an organization entity type.
The provider Is Doing Business As Lac Courte Oreilles Community Health Center.

The provider's business location address is:

13380 W TREPANIA RD
HAYWARD, WI
ZIP 54843-186
Phone: (715) 638-5100
Fax: (715) 634-6107

The provider's authorized official is Greg Duffek .
The authorized official title is Health Director and has the following contact phone number (715) 638-5100.

The enumeration date for this NPI number is 5/22/2007 and was last updated on 12/3/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	1486	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1982813390	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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