Provider Demographics
NPI:1114190485
Name:COLUMBIA COUNTY HHSD
Entity Type:Organization
Organization Name:COLUMBIA COUNTY HHSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-742-9215
Mailing Address - Street 1:2652 MURPHY RD
Mailing Address - Street 2:P.O. BOX 136
Mailing Address - City:PORTAGE
Mailing Address - State:WI
Mailing Address - Zip Code:53901-1094
Mailing Address - Country:US
Mailing Address - Phone:608-742-9227
Mailing Address - Fax:608-742-9700
Practice Address - Street 1:2652 MURPHY RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:WI
Practice Address - Zip Code:53901-1094
Practice Address - Country:US
Practice Address - Phone:608-742-9227
Practice Address - Fax:608-742-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43071200Medicaid