Fond Du Lac Co Dcp Ccs Program

LBN: Fond Du Lac Co Dcp Ccs Program
Fond Du Lac Co Dcp Ccs Program is an health care organization with primary practice located at 459 E 1St St , Fond Du Lac WI 54935-4505. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Fond Du Lac Co Dcp Ccs Program can be contacted via phone (920) 929-3500, or through Mcmeen, Mary Ellen via phone (920) 929-3500.

Contact Information

Primary practice address
459 E 1St St Fond Du Lac WI 54935-4505
Phone: (920) 929-3500
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mcmeen, Mary Ellen
Phone: (920) 929-3500

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1255454047
LBN Legal business name Fond Du Lac Co Dcp Ccs Program
DBA Doing business as
Authorized official Mcmeen, Mary Ellen
Entity Organization
Organization subpart 1 No
Enumeration date Apr 9th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255454047 NPPES
Wisconsin MEDICAID 41763000

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