Organization
POLK COUNTY DEPT OF ADMINISTRATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN GINGRAS (DIRECTOR BUSINESS & OPERATIONS)
(715) 485-8506
Entity
Organization
Contact information
Practice address
100 POLK COUNTY PLZ STE 180, BALSAM LAKE, WI 54810-8009
(715) 485-8400
(715) 485-8490
Mailing address
100 POLK COUNTY PLZ STE 50, BALSAM LAKE, WI 54810-9097
(715) 485-8400
(715) 485-8490
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
2222
WI
251E00000X
Home Health Agency
—
WI
251S00000X
Community/Behavioral Health Agency
Primary
2204
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31876
HEALTH PARTNERS
WI
01
—
37F35PO
BC BS MN
WI
05
—
42218400
—
WI
05
—
43074800
—
WI
05
—
43102400
—
WI
05
—
43430200
—
WI
01
—
66373
PREFERRED ONE
WI
01
—
84 81085
UNITED BEHAVIORAL HEALTH
WI
Enumeration date
04/10/2007
Last updated
04/08/2022
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