Provider Demographics
NPI:1578629721
Name:LA CROSSE COUNTY HUMAN SERVICES
Entity Type:Organization
Organization Name:LA CROSSE COUNTY HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, HUMAN SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-785-6094
Mailing Address - Street 1:300 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-3228
Mailing Address - Country:US
Mailing Address - Phone:608-785-6101
Mailing Address - Fax:608-793-6560
Practice Address - Street 1:300 4TH ST N
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-3228
Practice Address - Country:US
Practice Address - Phone:608-785-6101
Practice Address - Fax:608-793-6560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2594251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41761500Medicaid