Provider Demographics
NPI:1316397441
Name:ADRC OF WASHINGTON COUNTY
Entity type:Organization
Organization Name:ADRC OF WASHINGTON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR, ELDER NUTRITION/WELLNES
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSKING
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CD
Authorized Official - Phone:262-335-4497
Mailing Address - Street 1:333 E WASHINGTON ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-2501
Mailing Address - Country:US
Mailing Address - Phone:262-335-4497
Mailing Address - Fax:262-335-4717
Practice Address - Street 1:333 E WASHINGTON ST STE 1000
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-2501
Practice Address - Country:US
Practice Address - Phone:262-335-4497
Practice Address - Fax:262-335-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals