Organization
SOKAOGON CHIPPEWA COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS MCGESHICK (CLINIC DIRECTOR)
(715) 478-5180
Entity
Organization
Contact information
Practice address
3144 VANZILE RD, CRANDON, WI 54520-8149
(715) 478-5180
(715) 478-5904
Mailing address
3144 VANZILE RD, CRANDON, WI 54520-8149
(715) 478-5180
(715) 478-5904
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
32957000
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32957000
—
WI
Enumeration date
06/21/2005
Last updated
03/25/2025
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