Provider Demographics
NPI:1720521743
Name:D.O.E.R.S
Entity type:Organization
Organization Name:D.O.E.R.S
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-635-0179
Mailing Address - Street 1:336 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53911
Mailing Address - Country:US
Mailing Address - Phone:608-635-0179
Mailing Address - Fax:
Practice Address - Street 1:336 BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53911-8554
Practice Address - Country:US
Practice Address - Phone:608-635-0179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty