Provider Demographics
NPI:1326782772
Name:WCSC STEVENS POINT LLC
Entity Type:Organization
Organization Name:WCSC STEVENS POINT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:NOOYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-442-4472
Mailing Address - Street 1:PO BOX 28589
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54324-0589
Mailing Address - Country:US
Mailing Address - Phone:920-442-4472
Mailing Address - Fax:
Practice Address - Street 1:1820 POST RD STE 1
Practice Address - Street 2:
Practice Address - City:PLOVER
Practice Address - State:WI
Practice Address - Zip Code:54467-2883
Practice Address - Country:US
Practice Address - Phone:715-496-7696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care