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Organization
COUNTY OF WAUSHARA
Active
Organization
COUNTY OF WAUSHARA
Active
Other names
Waushara County Clinical Services, Waushara County
Organization subpart
No
Provider details
NPI number
Authorized official
JEN GONZALES (ACCOUNT CLERK)
(920) 787-6550
Entity
Organization
Contact information
Practice address
380 S TOWNLINE RD, WAUTOMA, WI 54982-6900
(207) 876-5509
Mailing address
380 S TOWNLINE RD, WAUTOMA, WI 54982-6900
(920) 787-6550
(920) 787-0421
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42140600
—
WI
Enumeration date
09/20/2006
Last updated
11/07/2024
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