| Lac Courte Oreilles Comprehensive Care Services | |
|
13380 W Trepania Rd Hayward WI 54843-2186 | |
| (715) 699-1695 | |
| (715) 634-6107 |
| Full Name | Lac Courte Oreilles Comprehensive Care Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 13380 W Trepania Rd, Hayward, Wisconsin |
| Authorized Official Name and Position | Tamara E Bergum (CCS ADMINISTRATOR) |
| Authorized Official Contact | 7156991695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lac Courte Oreilles Comprehensive Care Services 13380 W Trepania Rd Hayward WI 54843-2186 Ph: (715) 699-1695 | Lac Courte Oreilles Comprehensive Care Services 13380 W Trepania Rd Hayward WI 54843-2186 Ph: (715) 699-1695 |
| NPI Number | 1215453659 |
|---|---|
| Provider Enumeration Date | 08/17/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215453659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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