Lac Courte Oreilles Pncc Program

LBN: Lac Courte Oreilles Pncc Program
Lac Courte Oreilles Pncc Program is an health care organization with primary practice located at 13380 W Trepania Rd , Hayward WI 54843-2186. The organization recently has only one registered license in Agencies / Early Intervention Provider Agency, which is considered as the primary health care specialty. Lac Courte Oreilles Pncc Program can be contacted via phone (715) 638-5100, or through Baker, Rae E via phone (715) 638-5169.

Contact Information

Primary practice address
13380 W Trepania Rd Hayward WI 54843-2186
Phone: (715) 638-5100
Fax: (715) 634-6107
Website:
Map and Directions
Authorized official contact:
Name: Baker, Rae E
Phone: (715) 638-5169

Health care specialties

SpecialtyCodeLicense #State
Agencies / Early Intervention Provider Agency 252Y00000X

Profile Details

NPI number 1174848980
LBN Legal business name Lac Courte Oreilles Pncc Program
DBA Doing business as
Authorized official Baker, Rae E
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 5th, 2010
Last updated May 27th, 2010 - about 16 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 1174848980 NPPES
Wisconsin MEDICAID 44007600

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