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Organization

POLK COUNTY-DEPT OF ADMINISTRATION

Active
Other names
Polk County Home Care
Organization subpart
No

Provider details

NPI number
Authorized official
GRETCHEN SAMPSON RN, MPH (DIRECTOR)
(715) 485-8500
Entity
Organization

Contact information

Practice address
100 POLK COUNTY PLZ, SUITE 180, BALSAM LAKE, WI 54810-9071
(715) 485-8500
(715) 485-8501
Mailing address
100 POLK COUNTY PLZ, SUITE 180, BALSAM LAKE, WI 54810-9071
(715) 485-8500
(715) 485-8501

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
92
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41520900
WI
Enumeration date
04/17/2007
Last updated
10/21/2011
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