COUNTY OF SHAWANO NPI 1720088495

NPI Information

  • NPI: 1720088495
  • Provider Name: COUNTY OF SHAWANO
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • Doing Business As: MAPLE LANE HEALTH CARE CENTER
  • Address: N4231 STATE HIGHWAY 22
    SHAWANO, WI
    ZIP 54166
  • Phone: (715) 526-3158

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NPI Details

COUNTY OF SHAWANO is an intermediate care facility mentally retarded in Shawano, WI. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. COUNTY OF SHAWANO NPI is 1720088495. The provider is registered as an organization entity type.
The provider Is Doing Business As Maple Lane Health Care Center.

The provider's business location address is:

N4231 STATE HIGHWAY 22
SHAWANO, WI
ZIP 54166-130
Phone: (715) 526-3158
Fax: (715) 526-6823

The provider's authorized official is Debbra R Kessen .
The authorized official title is Accountant/controller and has the following contact phone number (715) 526-3158.

The enumeration date for this NPI number is 7/26/2005 and was last updated on 9/10/2007.

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
1315P00000XIntermediate Care Facility, Intellectual Disabilities2994WISCONSINYes

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
121051100MEDICAIDWISCONSIN

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

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