Organization
JEFFERSON COUNTY
Active
Other names
Jefferson County Human Service Dept-Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN BELLFORD CPA (DEPUTY DIRECTOR)
(920) 674-8147
Entity
Organization
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549
(920) 674-3105
(920) 674-6113
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549
(920) 674-3105
(920) 674-6113
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1449
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42138100
—
WI
Enumeration date
10/18/2006
Last updated
09/12/2024
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