Provider Demographics
NPI:1104930866
Name:COUNTY OF ADAMS
Entity type:Organization
Organization Name:COUNTY OF ADAMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FISCAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-339-4505
Mailing Address - Street 1:108 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:FRIENDSHIP
Mailing Address - State:WI
Mailing Address - Zip Code:53934-9443
Mailing Address - Country:US
Mailing Address - Phone:608-339-4505
Mailing Address - Fax:608-339-4593
Practice Address - Street 1:108 E NORTH ST
Practice Address - Street 2:
Practice Address - City:FRIENDSHIP
Practice Address - State:WI
Practice Address - Zip Code:53934-9443
Practice Address - Country:US
Practice Address - Phone:608-339-4505
Practice Address - Fax:608-339-4593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1253101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43109000Medicaid
WI42117800Medicaid
WI43079900Medicaid
WI43070000Medicaid
WI42117800Medicaid