Provider Demographics
NPI:1194686469
Name:NEW RICHMOND FAMILY CARE, LLC
Entity type:Organization
Organization Name:NEW RICHMOND FAMILY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAZLE
Authorized Official - Middle Name:COURTNEY
Authorized Official - Last Name:BALLINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-688-6008
Mailing Address - Street 1:1030 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54868-2657
Mailing Address - Country:US
Mailing Address - Phone:715-475-1336
Mailing Address - Fax:833-902-3994
Practice Address - Street 1:1030 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-2657
Practice Address - Country:US
Practice Address - Phone:715-475-1336
Practice Address - Fax:833-902-3994
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW RICHMOND FAMILY CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty