Provider Demographics
NPI:1275700338
Name:CALUMET COUNTY
Entity Type:Organization
Organization Name:CALUMET COUNTY
Other - Org Name:DEPT OF HEALTH AND HUMAN SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNTY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMENESKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-849-1448
Mailing Address - Street 1:206 COURT ST
Mailing Address - Street 2:
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014-1127
Mailing Address - Country:US
Mailing Address - Phone:920-849-1400
Mailing Address - Fax:920-849-1468
Practice Address - Street 1:206 COURT ST
Practice Address - Street 2:
Practice Address - City:CHILTON
Practice Address - State:WI
Practice Address - Zip Code:53014-1127
Practice Address - Country:US
Practice Address - Phone:920-849-1400
Practice Address - Fax:920-849-1468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41762100Medicaid