Organization
COUNTY OF OUTAGAMIE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RATHMAN (INTERIM DIRECTOR HHS)
(920) 832-5187
Entity
Organization
Contact information
Practice address
320 S. WALNUT ST., APPLETON, WI 54911-5918
(920) 832-4741
(920) 832-5164
Mailing address
320 S. WALNUT ST., APPLETON, WI 54911-5918
(920) 832-4741
(920) 832-5164
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
1724
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10038416
—
WI
05
—
32978671
—
WI
05
—
41761200
—
WI
05
—
41869100
—
WI
05
—
42139100
—
WI
05
—
43074500
—
WI
05
—
43106700
—
WI
05
—
43426000
—
WI
05
—
44012800
—
WI
Enumeration date
12/09/2006
Last updated
05/02/2025
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