Provider Demographics
NPI:1275791154
Name:WASHBURN COUNTY HEALTH AND HUMAN SERVICES DEPT
Entity Type:Organization
Organization Name:WASHBURN COUNTY HEALTH AND HUMAN SERVICES DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-468-4747
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:110 4TH AVE W
Mailing Address - City:SHELL LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54871-0250
Mailing Address - Country:US
Mailing Address - Phone:715-468-4747
Mailing Address - Fax:715-468-4753
Practice Address - Street 1:110 4TH AVE W
Practice Address - Street 2:
Practice Address - City:SHELL LAKE
Practice Address - State:WI
Practice Address - Zip Code:54871
Practice Address - Country:US
Practice Address - Phone:715-468-4747
Practice Address - Fax:715-468-4753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41232400Medicaid