| Ics-family Partners | |
|
17a W Davenport St Rhinelander WI 54501-0742 | |
| (715) 369-6955 | |
| Not Available |
| Full Name | Ics-family Partners |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 17a W Davenport St, Rhinelander, Wisconsin |
| Authorized Official Name and Position | John A Hinz (BUSINESS MANAGER) |
| Authorized Official Contact | 7153696955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ics-family Partners Po Box 13251 15655 County Road B Hayward WI 54843-3251 Ph: (715) 634-0607 | Ics-family Partners 17a W Davenport St Rhinelander WI 54501-0742 Ph: (715) 369-6955 |
| NPI Number | 1740425941 |
|---|---|
| Provider Enumeration Date | 12/03/2008 |
| Last Update Date | 12/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740425941 | NPI | - | NPPES |
| 42221700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 42221700 (Wisconsin) | Primary |
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