Provider Demographics
NPI:1457519076
Name:COUNTY OF MENOMINEE
Entity Type:Organization
Organization Name:COUNTY OF MENOMINEE
Other - Org Name:MENOMINEE COUNTY HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-799-3861
Mailing Address - Street 1:P O BOX 280
Mailing Address - Street 2:W3272 WOLF RIVER RD
Mailing Address - City:KESHENA
Mailing Address - State:WI
Mailing Address - Zip Code:54135
Mailing Address - Country:US
Mailing Address - Phone:715-799-3861
Mailing Address - Fax:715-799-3517
Practice Address - Street 1:W3272 WOLF RIVER DR
Practice Address - Street 2:
Practice Address - City:KESHENA
Practice Address - State:WI
Practice Address - Zip Code:54135-9202
Practice Address - Country:US
Practice Address - Phone:715-799-3861
Practice Address - Fax:715-799-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1587251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare