Organization
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
Active
Parent organization
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
Other names
Black River Falls PNCC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
Authorized official
SHEILA REUTEMAN (SR. CREDENTIALING COORDINATOR)
(414) 266-7615
Entity
Organization
Contact information
Practice address
W11109 ROGERS RD, BLACK RIVER FALLS, WI 54615-6051
(715) 284-3001
(715) 284-3005
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1186
LICENSE
WI
Enumeration date
03/13/2019
Last updated
05/01/2019
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