Provider Demographics
NPI:1104370014
Name:COUNTY OF SHEBOYGAN
Entity Type:Organization
Organization Name:COUNTY OF SHEBOYGAN
Other - Org Name:SHEBOYGAN COUNTY HEALTH AND HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:EGGEBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-459-3213
Mailing Address - Street 1:1011 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-4006
Mailing Address - Country:US
Mailing Address - Phone:920-459-4339
Mailing Address - Fax:920-459-4353
Practice Address - Street 1:1011 N 8TH ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4006
Practice Address - Country:US
Practice Address - Phone:920-459-4339
Practice Address - Fax:920-459-4353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation