# INDIANHEAD MEDICAL CENTER SHELL LAKE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INDIANHEAD MEDICAL CENTER SHELL LAKE INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629110077
- **Legal business name:** INDIANHEAD MEDICAL CENTER SHELL LAKE INC
- **Authorized official:** MRS. DORIS JEAN LAURSEN RN (ADMINISTRATOR)
- **Authorized official phone:** (715) 468-7833

## Contact information

- **Practice address:** 113 FOURTH AVE, SHELL LAKE, WI 54871
- **Practice address phone:** (715) 468-7833
- **Mailing address:** 113 FOURTH AVE, P.O. BOX 300, SHELL LAKE, WI 54871
- **Mailing address phone:** (715) 468-7833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 324 | WI | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 01/14/2016