Provider Demographics
NPI:1174027742
Name:COUNTY OF IRON
Entity Type:Organization
Organization Name:COUNTY OF IRON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:REIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-561-3636
Mailing Address - Street 1:300 TACONITE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:WI
Mailing Address - Zip Code:54534-1545
Mailing Address - Country:US
Mailing Address - Phone:715-561-3636
Mailing Address - Fax:715-561-2128
Practice Address - Street 1:300 TACONITE ST STE 201
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:WI
Practice Address - Zip Code:54534-1545
Practice Address - Country:US
Practice Address - Phone:715-561-3636
Practice Address - Fax:715-561-2128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3193251S00000X, 261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health