Provider Demographics
NPI:1326235524
Name:WAUSHARA COUNTY GOVERNMENT
Entity Type:Organization
Organization Name:WAUSHARA COUNTY GOVERNMENT
Other - Org Name:WAUSHARA CO DEPT OF HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNT CLERK
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:STANDKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-787-6551
Mailing Address - Street 1:205 W ELM ST
Mailing Address - Street 2:PO BOX 1230
Mailing Address - City:WAUTOMA
Mailing Address - State:WI
Mailing Address - Zip Code:54982
Mailing Address - Country:US
Mailing Address - Phone:920-787-6551
Mailing Address - Fax:920-787-0465
Practice Address - Street 1:205 W ELM ST
Practice Address - Street 2:
Practice Address - City:WAUTOMA
Practice Address - State:WI
Practice Address - Zip Code:54982
Practice Address - Country:US
Practice Address - Phone:920-787-6600
Practice Address - Fax:920-787-0465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41762000Medicaid