| Menominee Indian Tribe Of Wisconsin | |
|
W3275 Wolf River Road Keshena WI 54135 | |
| (715) 799-3361 | |
| (715) 799-3099 |
| Full Name | Menominee Indian Tribe Of Wisconsin |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | W3275 Wolf River Road, Keshena, Wisconsin |
| Authorized Official Name and Position | Jerry L Waukau (HEALTH ADMINISTRATOR) |
| Authorized Official Contact | 7157993361 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Menominee Indian Tribe Of Wisconsin Po Box 970 Keshena WI 54135-0970 Ph: (715) 799-3361 | Menominee Indian Tribe Of Wisconsin W3275 Wolf River Road Keshena WI 54135 Ph: (715) 799-3361 |
| NPI Number | 1124291802 |
|---|---|
| Provider Enumeration Date | 04/02/2008 |
| Last Update Date | 04/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124291802 | NPI | - | NPPES |
| 42173700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1588 (Wisconsin) | Primary |
Menominee County Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: W3272 Wolf River Driver, Keshena, WI 54135 Phone: 715-799-3861 | |
St Vincent Hospital-hospital Sisters-third Order Of St Francis Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: W3275 Wolf River Dr, Keshena, WI 54135 Phone: 715-799-5451 | |
Menominee County Health & Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: W3272 Wolf River Rd, Keshena, WI 54135 Phone: 715-799-3861 Fax: 715-799-3517 |