Organization
HO CHUNK NATION
Active
Parent organization
HO CHUNK NATION
Other names
Ho-Chunk Community Health Care Nursing Program
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
N6520 LUMBERJACK GUY RD, BLACK RIVER FALLS, WI 54615-5405
(715) 284-9851
(715) 284-5051
Mailing address
N6520 LUMBERJACK GUY RD, BLACK RIVER FALLS, WI 54615-5405
(715) 284-9851
(715) 284-5051
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44015100
—
WI
01
—
52D2018007
CLIA
WI
Enumeration date
07/22/2008
Last updated
03/23/2018
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