Provider Demographics
NPI:1114224359
Name:UNITED CEREBRAL PALSY OF WCW
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF WCW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BSNS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELKE
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-832-1782
Mailing Address - Street 1:206 WATER ST
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-5699
Mailing Address - Country:US
Mailing Address - Phone:715-832-1782
Mailing Address - Fax:
Practice Address - Street 1:206 WATER ST
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-5699
Practice Address - Country:US
Practice Address - Phone:715-832-1782
Practice Address - Fax:715-832-8203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management