Provider Demographics
NPI:1578751277
Name:COUNTY OF DUNN
Entity Type:Organization
Organization Name:COUNTY OF DUNN
Other - Org Name:DUNN COUNTY DEPARTMENT OF HUMAN SERVICES & ADRC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-231-2750
Mailing Address - Street 1:3001 US HIGHWAY 12 E STE 225
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-3045
Mailing Address - Country:US
Mailing Address - Phone:715-231-2771
Mailing Address - Fax:715-232-5987
Practice Address - Street 1:3001 US HIGHWAY 12 E STE 160
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-3045
Practice Address - Country:US
Practice Address - Phone:715-232-1116
Practice Address - Fax:715-232-5987
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF DUNN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-09
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225X00000X, 225XP0200X, 261QR0400X, 261QR0400X
WI1325-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1018589OtherPREFERRED ONE 0-3 ID
WI67551DUOtherCOMPREHENSIVE CARE SERV
WI100122787Medicaid
WI41011800Medicaid
WI60011400OtherWI MA TRADING PARTNER ID
MN9009DUOtherBC & BS OF MN PROVIDER ID