Provider Demographics
NPI:1801069406
Name:FLORENCE COUNTY HUMAN SERVICES DEPARTMENT
Entity type:Organization
Organization Name:FLORENCE COUNTY HUMAN SERVICES DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-528-3470
Mailing Address - Street 1:501 LAKE AVENUE
Mailing Address - Street 2:PO BOX 170 COURTHOUSE LOWERLEVEL
Mailing Address - City:FLORENCE
Mailing Address - State:WI
Mailing Address - Zip Code:54121-0170
Mailing Address - Country:US
Mailing Address - Phone:715-528-3296
Mailing Address - Fax:715-528-3341
Practice Address - Street 1:501 LAKE AVENUE
Practice Address - Street 2:COURTHOUSE LOWERLEVEL
Practice Address - City:FLORENCE
Practice Address - State:WI
Practice Address - Zip Code:54121-0170
Practice Address - Country:US
Practice Address - Phone:715-528-3296
Practice Address - Fax:715-528-3341
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORENCE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-04
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43079300Medicaid
WI43114900Medicaid