Provider Demographics
NPI:1346514486
Name:SOUTHWESTERN WISCONSIN COMMUNITY ACTION PROGRAM, INC.
Entity Type:Organization
Organization Name:SOUTHWESTERN WISCONSIN COMMUNITY ACTION PROGRAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR TRANSPORTATION DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEDEAU-OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-930-2191
Mailing Address - Street 1:201 S IOWA ST
Mailing Address - Street 2:
Mailing Address - City:DODGEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53533-1739
Mailing Address - Country:US
Mailing Address - Phone:608-930-2191
Mailing Address - Fax:608-319-2124
Practice Address - Street 1:201 S IOWA ST
Practice Address - Street 2:
Practice Address - City:DODGEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53533-1739
Practice Address - Country:US
Practice Address - Phone:608-930-2191
Practice Address - Fax:608-319-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker