Organization
WAUSHARA COUNTY
Active
Parent organization
WAUSHARA COUNTY CLINICAL SERVICES
Other names
Waushara County Crisis Intervention
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAUSHARA COUNTY CLINICAL SERVICES
Authorized official
VICTORIA L IDA (ACCOUNT CLERK)
(920) 787-6618
Entity
Organization
Contact information
Practice address
230 W PARK STREET, WAUTOMA, WI 54982-9031
(920) 787-6550
(920) 787-0421
Mailing address
PO BOX 1230, WAUTOMA, WI 54982-1230
(920) 787-6600
(920) 787-6670
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1980
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32976970
—
WI
Enumeration date
04/10/2008
Last updated
12/29/2014
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