Organization
LA CLINICA DE LOS CAMPESINOS, INC
Active
Organization
LA CLINICA DE LOS CAMPESINOS, INC
Active
Other names
Noble Community Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN BENDER (ENROLLMENT AND CONTRACT SPECIALIST)
(920) 787-9459
Entity
Organization
Contact information
Practice address
2501 MAIN ST, STEVENS POINT, WI 54481-4000
(715) 254-9072
(715) 254-9106
Mailing address
PO BOX 1440, WAUTOMA, WI 54982-1440
(920) 787-5514
(920) 787-4737
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
WI
207Q00000X
Family Medicine Physician
—
WI
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100076513
—
WI
05
—
100076692
—
WI
05
—
100080272
—
WI
05
—
100084424
—
WI
05
—
100224438
—
WI
05
—
100237113
—
WI
05
—
100253468
—
WI
05
—
32955200
—
WI
Enumeration date
08/10/2005
Last updated
11/21/2025
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