PREMIER CARE OF WISCONSIN LLC. NPI 1346620952

NPI Information

NPI: 1346620952
Provider Name: PREMIER CARE OF WISCONSIN, LLC.
Classification: Clinic/Center - 261QM2800X
Specialization: Methadone
Entity Type: Organization
Doing Business As: CMS FOND DU LAC
CLIA Number: 52D2100462
Address: 23 W SCOTT ST
FOND DU LAC, WI
ZIP 54935
Phone: (920) 926-0101

Map and Directions

Get Directions

NPI Details

PREMIER CARE OF WISCONSIN, LLC. is a methadone clinic center in Fond Du Lac, WI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. PREMIER CARE OF WISCONSIN, LLC. NPI is 1346620952. The provider is registered as an organization entity type.
The provider Is Doing Business As Cms Fond Du Lac.

The provider's business location address is:

23 W SCOTT ST
FOND DU LAC, WI
ZIP 54935-342
Phone: (920) 926-0101

The provider's authorized official is Cindy Gaither .
The authorized official title is Vp Revenue Cycle Mgmt and has the following contact phone number (602) 248-8886.

The CLIA number assigned to this NPI record is 52D2100462 - other - narcotic treatment provid with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/9/2015 and was last updated on 2/10/2024.

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)			No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No
4	251S00000X	Community/Behavioral Health		3075	WISCONSIN	No
5	261QM2800X	Clinic/Center	Methadone			Yes

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI