Organization
HO CHUNK NATION
Active
Parent organization
HO CHUNK NATION
Other names
Ho-Chunk Behavioral Health Care - Tomah
Organization subpart
Yes
Provider details
NPI number
Legal business name
HO CHUNK NATION
Authorized official
MS. LIZ M LUND (PROVIDER NETWORK MANAGER)
(715) 284-9851
Entity
Organization
Contact information
Practice address
27374 STATE HIGHWAY 21, TOMAH, WI 54660-4501
(608) 372-5813
(608) 372-0889
Mailing address
N6520 LUMBERJACK GUY RD, BLACK RIVER FALLS, WI 54615-5405
(715) 284-9851
(715) 284-5150
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1413
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1413
STATE CERTIFICATION
WI
Enumeration date
10/06/2010
Last updated
03/27/2018
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