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Organization

ST CROIX COUNTY

Active
Other names
St. Croix County Birth to Three
Organization subpart
No

Provider details

NPI number
Authorized official
FAY STRENKE (ACCOUNTS RECEIVABLE SUPERVISOR)
(715) 246-8217
Entity
Organization

Contact information

Practice address
1752 DORSET LN, NEW RICHMOND, WI 54017-2452
(715) 246-6991
(715) 246-8413
Mailing address
1752 DORSET LN, NEW RICHMOND, WI 54017-2452
(715) 246-6991
(715) 246-8413

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41211600
WI
Enumeration date
04/02/2019
Last updated
11/06/2020
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