Provider Demographics
NPI:1003065574
Name:COMMUNITY HEALTH RESOURCES
Entity Type:Organization
Organization Name:COMMUNITY HEALTH RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOVITZKE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-BC
Authorized Official - Phone:715-762-4600
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:1133 S. 4TH AVENUE
Mailing Address - City:PARK FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54552-0110
Mailing Address - Country:US
Mailing Address - Phone:715-762-4600
Mailing Address - Fax:715-762-2835
Practice Address - Street 1:1133 4TH AVE S
Practice Address - Street 2:
Practice Address - City:PARK FALLS
Practice Address - State:WI
Practice Address - Zip Code:54552-1922
Practice Address - Country:US
Practice Address - Phone:715-762-4600
Practice Address - Fax:715-762-2835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI41868100251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care