Organization
COUNTY OF PIERCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE A BRICKNER (FINANCE DIRECTOR)
(715) 273-6765
Entity
Organization
Contact information
Practice address
412 W KINNE ST, ELLSWORTH, WI 54011
(715) 273-6770
(715) 273-6862
Mailing address
PO BOX 670, ELLSWORTH, WI 54011-0670
(715) 273-6770
(715) 273-6862
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
1737
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42115600
—
WI
Enumeration date
11/21/2006
Last updated
03/21/2022
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