| Jefferson County | |
|
1541 Annex Rd Jefferson WI 53549-9803 | |
| (920) 674-3105 | |
| (920) 674-6113 |
| Full Name | Jefferson County |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1541 Annex Rd, Jefferson, Wisconsin |
| Authorized Official Name and Position | Kathleen M Cauley (DIRECTOR) |
| Authorized Official Contact | 9206748111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson County 1541 Annex Rd Jefferson WI 53549-9803 Ph: (920) 674-3105 | Jefferson County 1541 Annex Rd Jefferson WI 53549-9803 Ph: (920) 674-3105 |
| NPI Number | 1578562286 |
|---|---|
| Provider Enumeration Date | 07/15/2005 |
| Last Update Date | 10/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578562286 | NPI | - | NPPES |
| 4333090001 | Other | WI | MEDICARE DMERC |
| 525700 | Other | WI | DEAN HEALTH PLAN |
| 20141600 | Medicaid | WI | |
| 42138100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1449 (Wisconsin) | Primary |
Wellnite Medical Group Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 148 E Milwaukee St, Jefferson, WI 53549 Phone: 877-644-6008 | |
Unique In Home Personal Care Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 148 E Milwaukee St Unit 1125, Jefferson, WI 53549 Phone: 608-640-2720 | |
K Bare Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1031 S Main Street, Jefferson, WI 53549 Phone: 920-541-3677 Fax: 920-541-3678 | |
Jefferson County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1541 Annex Rd, Jefferson, WI 53549 Phone: 920-674-3105 Fax: 920-674-6113 | |
Jefferson County Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1541 Annex Rd, Jefferson, WI 53549 Phone: 920-674-3105 Fax: 920-674-6113 | |
Jefferson County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1541 Annex Rd, Jefferson, WI 53549 Phone: 920-674-3105 Fax: 920-674-6113 | |
Jefferson County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1541 Annex Rd, Jefferson, WI 53549 Phone: 920-674-3105 Fax: 920-674-6113 |