Provider Demographics
NPI:1467642264
Name:DEPARTMENT OF HEALTH & FAMILY SERVICES
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH & FAMILY SERVICES
Other - Org Name:DIVISION OF CHILDREN & FAMILY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:FISCAL LIAISON
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:POMERENING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-267-9712
Mailing Address - Street 1:PO BOX 8916
Mailing Address - Street 2:ROOM 550
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53708-8916
Mailing Address - Country:US
Mailing Address - Phone:608-267-9712
Mailing Address - Fax:608-266-6836
Practice Address - Street 1:1 W WILSON ST
Practice Address - Street 2:ROOM 550
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3445
Practice Address - Country:US
Practice Address - Phone:608-267-9712
Practice Address - Fax:608-266-6836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF WISCONSIN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43084700Medicaid