Organization
JEFFERSON COUNTY
Active
Parent organization
JEFFERSON COUNTY
Other names
JEFFERSON COUNTY HUMAN SERVICES - CCS BILLING PROVIDER
Organization subpart
Yes
Provider details
NPI number
Legal business name
JEFFERSON COUNTY
Authorized official
BRIAN BELLFORD CPA (DEPUTY DIRECTOR)
(920) 674-8147
Entity
Organization
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
(920) 674-6113
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
(920) 674-6113
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2643
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41762800
—
WI
Enumeration date
03/06/2007
Last updated
09/12/2024
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