Organization
HUMAN SERVICES BOARD SERVING NORTH CENTRAL HEATLH CARE
Active
Other names
North Central Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LOY (INTERIM CEO)
(715) 848-4600
Entity
Organization
Contact information
Practice address
1225 LANGLADE RD, ANTIGO, WI 54409-2762
(715) 623-2394
Mailing address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6785
(715) 848-4600
(715) 845-5398
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
1676
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42170800
—
WI
Enumeration date
08/20/2006
Last updated
08/01/2017
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