Organization
COUNTY OF COLUMBIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER GOVE (HHS DIRECTOR)
(608) 742-9715
Entity
Organization
Contact information
Practice address
111 E MULLETT ST, PORTAGE, WI 53901-2325
(608) 742-9227
(608) 742-9700
Mailing address
PO BOX 136, PORTAGE, WI 53901-0136
(608) 742-9227
(608) 742-9700
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44000100
—
WI
Enumeration date
05/07/2008
Last updated
05/02/2025
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