Provider Demographics
NPI:1568645604
Name:TAYLOR COUNTY
Entity Type:Organization
Organization Name:TAYLOR COUNTY
Other - Org Name:TAYLOR COUNTY HUMAN SERVICES DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-748-3332
Mailing Address - Street 1:540 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54451-2027
Mailing Address - Country:US
Mailing Address - Phone:715-748-3332
Mailing Address - Fax:715-748-3342
Practice Address - Street 1:540 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451-2027
Practice Address - Country:US
Practice Address - Phone:715-748-3332
Practice Address - Fax:715-748-3342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41223400Medicaid