Provider Demographics
NPI:1881813152
Name:COUNTY OF MONROE
Entity type:Organization
Organization Name:COUNTY OF MONROE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-269-8600
Mailing Address - Street 1:210 WEST OAK STREET
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-1796
Mailing Address - Country:US
Mailing Address - Phone:608-269-8600
Mailing Address - Fax:608-269-8935
Practice Address - Street 1:210 WEST OAK ST.
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656-1796
Practice Address - Country:US
Practice Address - Phone:608-269-8600
Practice Address - Fax:608-269-8935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42138900Medicaid
WIB85183Medicare UPIN
WI42138900Medicaid