Provider Demographics
NPI:1073780425
Name:GRANT COUNTY DEPARTMENT OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:GRANT COUNTY DEPARTMENT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:NAATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-723-2136
Mailing Address - Street 1:8820 HWY 35 AND 61
Mailing Address - Street 2:P.O. BOX 447
Mailing Address - City:LANCASTER
Mailing Address - State:WI
Mailing Address - Zip Code:53813-9306
Mailing Address - Country:US
Mailing Address - Phone:608-723-2136
Mailing Address - Fax:608-723-4834
Practice Address - Street 1:8820 HWY 35 AND 61
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:WI
Practice Address - Zip Code:53813-9306
Practice Address - Country:US
Practice Address - Phone:608-723-2136
Practice Address - Fax:608-723-4834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43072300OtherCASE MANAGEMENT