Provider Demographics
NPI:1396938270
Name:DANE COUNTY DEPARTMENT OF HUMAN SERVICES
Entity type:Organization
Organization Name:DANE COUNTY DEPARTMENT OF HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:DOLLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'LAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-242-6314
Mailing Address - Street 1:1202 NORTHPORT DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-2020
Mailing Address - Country:US
Mailing Address - Phone:608-242-6314
Mailing Address - Fax:608-242-6246
Practice Address - Street 1:1202 NORTHPORT DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-2020
Practice Address - Country:US
Practice Address - Phone:608-242-6314
Practice Address - Fax:608-242-6246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43071500Medicaid