| County Of Grant | |
|
200 W Alona Ln Lancaster WI 53813-2202 | |
| (608) 723-6357 | |
| (608) 723-4417 |
| Full Name | County Of Grant |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 200 W Alona Ln, Lancaster, Wisconsin |
| Authorized Official Name and Position | Jan Sudmeier (COMPTROLLER) |
| Authorized Official Contact | 6087236357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| County Of Grant 200 W Alona Ln Lancaster WI 53813-2202 Ph: (608) 723-6357 | County Of Grant 200 W Alona Ln Lancaster WI 53813-2202 Ph: (608) 723-6357 |
| NPI Number | 1588618789 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 04/23/2009 |
| Medicare PECOS PAC ID | 0244212959 |
|---|---|
| Medicare Enrollment ID | O20040607000011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588618789 | NPI | - | NPPES |
| 41215000 | Medicaid | WI | |
| 43420600 | Medicaid | WI | |
| 42127200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Louis M Fulton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093702383 PECOS PAC ID: 4082777446 Enrollment ID: I20090110000206 |
| Provider Name | Becky R Manning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285954297 PECOS PAC ID: 1456475318 Enrollment ID: I20100828000200 |
| Provider Name | Aeron R Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477079242 PECOS PAC ID: 8325314545 Enrollment ID: I20171016002333 |
| Provider Name | Diana E Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841778099 PECOS PAC ID: 9931450178 Enrollment ID: I20180926003463 |
| Provider Name | Keri Lynn Fatzinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972979227 PECOS PAC ID: 3779822184 Enrollment ID: I20190301001592 |
Empowerment Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 S Madison St, Lancaster, WI 53813 Phone: 815-291-6844 | |
County Of Grant Dba Unified Community Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 W Alona Ln, Lancaster, WI 53813 Phone: 608-723-6357 Fax: 608-723-4417 | |
County Of Grant, Office Of Clerk Dba Unified Community Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 W Alona Ln, Lancaster, WI 53813 Phone: 608-723-6357 Fax: 608-723-4417 | |
County Of Grant, Office Of Clerk Dba Unified Community Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 W Alona Ln, Lancaster, WI 53813 Phone: 608-723-6357 Fax: 608-723-4417 |