# TOWN OF LONG LAKE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225536527
- **Authorized official:** JEFF KISLEWSKI (DIRECTOR)
- **Authorized official phone:** (717) 724-4136

## Contact information

- **Practice address:** 3348 WISCONSIN 139, LONG LAKE, WI 54542
- **Practice address phone:** (715) 674-2263
- **Mailing address:** PO BOX 138, LONG LAKE, WI 54542-0138
- **Mailing address phone:** (715) 674-2263

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 6604974 | WI | Yes |

## Other

- **Enumeration date:** 02/01/2018
- **Last updated:** 02/01/2018