Organization
SHAWANO COUNTY DEPARTMENT OF COMMUNITY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA LARSON-HERBER (EXECUTIVE PROGRAM DIRECTOR)
(715) 526-5547
Entity
Organization
Contact information
Practice address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-5547
(715) 526-5542
Mailing address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-5547
(715) 526-5542
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2242
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43425800
—
WI
Enumeration date
05/16/2008
Last updated
05/16/2008
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