Provider Demographics
NPI:1457528598
Name:LINCOLN COUNTY 51.437 SERVICES
Entity type:Organization
Organization Name:LINCOLN COUNTY 51.437 SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-536-0350
Mailing Address - Street 1:PO BOX 710
Mailing Address - Street 2:912 N MEMORIAL DR
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452
Mailing Address - Country:US
Mailing Address - Phone:715-536-0350
Mailing Address - Fax:715-536-6146
Practice Address - Street 1:912 N MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452
Practice Address - Country:US
Practice Address - Phone:715-536-0350
Practice Address - Fax:715-536-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40400700Medicaid
WI41223900Medicaid
WI43073400Medicaid