52D2163161 CLIA NUMBER - SHAWANO COUNTY DEPARTMENT OF HUMAN SERVICES

Laboratory Demographics

CLIA Number: 52D2163161

Facility Name: SHAWANO COUNTY DEPARTMENT OF HUMAN SERVICES

Facility Address:
W7327 ANDERSON AVE
SHAWANO, WI
ZIP 54166
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Facility Phone Number: 715 526-4700

Facility Type: Other - COUNTY HUMAN SERVICES

Certificate Type: Waiver

NPI Number: 1558528729

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	52D2163161
LAB Type	Other - COUNTY HUMAN SERVICES
Facility Name	SHAWANO COUNTY DEPARTMENT OF HUMAN SERVICES
Street	W7327 ANDERSON AVE
City	SHAWANO
State	WI
ZIP	54166
Phone	715 526-4700
CertificateType	4
CertificateEffectiveDate	3/8/2023
CertificateExpirationDate	3/7/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024