Organization
RUSK COUNTY CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA OLSON LICENSED CLINCAL SOC (CLINICAL COORDINATOR)
(715) 532-5940
Entity
Organization
Contact information
Practice address
219 W 2ND ST NORTH, LADY SMITH, WI 54848
(715) 532-5940
(715) 532-5947
Mailing address
219 W 2ND ST NORTH, LADYSMITH, WI 54848
(715) 532-5940
(715) 532-5947
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43429800
—
WI
Enumeration date
04/28/2008
Last updated
04/28/2008
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