Provider Demographics
NPI:1144404468
Name:ONEIDA COUNTY DEPARTMENT OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:ONEIDA COUNTY DEPARTMENT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:715-362-5695
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-0400
Mailing Address - Country:US
Mailing Address - Phone:715-362-5695
Mailing Address - Fax:715-362-7910
Practice Address - Street 1:ONE COURTHOUSE SQUARE
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501
Practice Address - Country:US
Practice Address - Phone:715-362-5695
Practice Address - Fax:715-362-7910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONEIDA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43074400Medicaid