Organization
COUNTY OF WAUSHARA
Active
Other names
Waushara County Clinical Services, Waushara County
Organization subpart
No
Provider details
NPI number
Authorized official
JEN GONZALES (ACCOUNT CLERK)
(920) 787-6550
Entity
Organization
Contact information
Practice address
380 S TOWNLINE RD, WAUTOMA, WI 54982-6900
(207) 876-5509
Mailing address
380 S TOWNLINE RD, WAUTOMA, WI 54982-6900
(920) 787-6550
(920) 787-0421
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42140600
—
WI
Enumeration date
09/20/2006
Last updated
11/07/2024
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