Provider Demographics
NPI:1558738872
Name:COUNTY OF JACKSON
Entity Type:Organization
Organization Name:COUNTY OF JACKSON
Other - Org Name:JACKSON COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-284-4301
Mailing Address - Street 1:421 COUNTY ROAD R
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54615-5129
Mailing Address - Country:US
Mailing Address - Phone:715-284-4301
Mailing Address - Fax:715-284-7713
Practice Address - Street 1:421 COUNTY ROAD R
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-5129
Practice Address - Country:US
Practice Address - Phone:715-284-4301
Practice Address - Fax:715-284-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency