Provider Demographics
NPI:1639246135
Name:CHIPPEWA COUNTY DHS
Entity Type:Organization
Organization Name:CHIPPEWA COUNTY DHS
Other - Org Name:CHIPPEWA COUNTY DHS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPT OF HUMAN SERVICES DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-726-7788
Mailing Address - Street 1:711 N BRIDGE STREET
Mailing Address - Street 2:RM 305
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-1876
Mailing Address - Country:US
Mailing Address - Phone:715-726-7788
Mailing Address - Fax:715-726-4560
Practice Address - Street 1:711 N BRIDGE STREET
Practice Address - Street 2:RM 122
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-1876
Practice Address - Country:US
Practice Address - Phone:715-726-7788
Practice Address - Fax:715-726-4560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1196251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42139900Medicaid
WI1167OtherSECURITY HEALTH
WI42139900Medicaid