Provider Demographics
NPI:1932375185
Name:COUNTY OF COLUMBIA
Entity type:Organization
Organization Name:COUNTY OF COLUMBIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HHS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-742-9715
Mailing Address - Street 1:PO BOX 136
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:WI
Mailing Address - Zip Code:53901-0136
Mailing Address - Country:US
Mailing Address - Phone:608-742-9227
Mailing Address - Fax:608-742-9700
Practice Address - Street 1:111 E MULLETT ST
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:WI
Practice Address - Zip Code:53901-2325
Practice Address - Country:US
Practice Address - Phone:608-742-9227
Practice Address - Fax:608-742-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44000100Medicaid