LAC COURTE OREILLES GOVERNING BOARD (NPI# 1215453659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215453659 |
| Entity Type | Organization |
| Organization Name | LAC COURTE OREILLES GOVERNING BOARD |
| Other Organization Name | LAC COURTE OREILLES COMPREHENSIVE CARE SERVICES |
| Practice Address |
13380 W Trepania Rd Hayward WI 54843-2186 |
| Practice Telephone | (715) 699-1695 |
| Practice Fax Number | 7156346107 |
| Mailing Telephone | 7156991695 |
| Mailing Fax Number | 7156346107 |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2017-08-17 |
| Authorized Official Name | TAMARA E BERGUM (CCS ADMINISTRATOR) |
| Authorized Official Telephone | 7156991695 |
| Is Organization Subpart | Y |
| Parent Organization Name | LAC COURTE OREILLES GOVERNING BOARD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Lac Courte Oreilles Comprehensive Care Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598890378 | Lac Courte Oreilles Governing Board | Clinic/Center | 13394 W Trepania Rd, Lac Courte Oreilles Governing Board, Hayward, WI 54843-2186 | 2007-02-22 |
| 1194830208 | Lac Courte Oreilles Governing Board | Clinic/Center | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2006-08-20 |
| 1982813390 | Lac Courte Oreilles Governing Board | Clinic/Center | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2007-05-22 |
| Street Address |
13380 W TREPANIA RD |
| City | HAYWARD |
| State | WI |
| Zip Code | 54843-2186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194830208 | Lac Courte Oreilles Governing Board | Clinic/Center | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2006-08-20 |
| 1942826847 | Dawn Marcel Quaderer | Registered Nurse | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2020-06-17 |
| 1265052146 | Danielle Hughes | Nurse Practitioner | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2020-04-21 |
| 1730727710 | Lynsey Michelle Weber | Registered Nurse | 13380 W Trepania Rd, Hayward, WI 54843 | 2019-12-20 |
| 1386299626 | Gina Marie Benson | Clinical Nurse Specialist | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2019-08-05 |
| 1477107282 | Christian M Clarquist | Registered Nurse | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2019-07-30 |
| 1063066082 | Krista Lee Strunk | Registered Nurse | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2019-07-29 |
| 1851945968 | Melinda Young | Registered Nurse | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2019-07-26 |
| 1790284966 | Jennifer L Petit | Counselor | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2018-02-02 |
| 1063927432 | Alexandra Bice | Counselor | 13380 W Trepania Rd, Hayward, WI 54843-2186 | 2017-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063011252 | Kelsey Eickstaedt | Pharmacist | 15594 State Hwy 77, Hayward, WI 54843 | 2020-10-20 |
| 1245687417 | Gary Girard | Counselor | 15655 W County Hwy B, Hayward, WI 54843 | 2016-05-18 |
| 1164844379 | Elizabeth Anne Johnson | Counselor | 10594 Main Street #1021, Hayward, WI 54843 | 2014-01-08 |
| 1376776922 | Amy Marilyn Billman | Massage Therapist | 11128n Highway 27/77, Hayward, WI 54843 | 2009-08-31 |
| 1700016516 | Kyra Rhodes Larson | Dentist | 15541w Hwy 77 East, Hayward, WI 54843 | 2009-07-15 |
| 1235383985 | Sara Jane Drost | Dental Hygienist | 15910 W Company Lake Road, Hayward, WI 54843 | 2008-11-07 |
| 1982856076 | Align Therapy,llc | In Home Supportive Care | 10767 Nyman Avenue, Hayward, WI 54843 | 2008-10-21 |
| 1316112477 | Michael John Larson | Hearing Instrument Specialist | 15612 Windrose Lane, #200, Hayward, WI 54843 | 2008-04-29 |
| 1679748966 | Gwendolyn Vinopal | Physical Therapist | 16014w Sleepy Hollow Drive, Hayward, WI 54843 | 2008-04-28 |
| 1558546523 | Ruth Anne Gillmor | Social Worker | 10610 Main, Hayward, WI 54843 | 2008-01-08 |
| Find all providers in zip 54843 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932670031 | Richmond Area Multi-services, Inc. | Community/Behavioral Health | 22712 Foothill Blvd, Hayward, CA 94541-4208 | 2018-12-16 |
| 1841732062 | Stars, Inc. | Community/Behavioral Health | 18250 Bengal Ave, Hayward, CA 94541-2202 | 2016-11-07 |
| 1396287413 | Stars, Inc. | Community/Behavioral Health | 28027 Dickens Ave, Hayward, CA 94544-5639 | 2016-11-07 |
| 1831644335 | Seneca Family of Agencies | Community/Behavioral Health | 31410 Wheelon Ave, Hayward, CA 94544-7662 | 2016-08-25 |
| 1225583883 | Superior Counseling, LLC | Community/Behavioral Health | 10594 Main St, Hayward, WI 54843-6658 | 2016-08-23 |
| 1336599570 | Memory Daybyday | Community/Behavioral Health | 111 Jackson St, Hayward, CA 94544-1948 | 2016-06-19 |
| 1497104533 | Seneca Family of Agencies | Community/Behavioral Health | 28000 Calaroga Ave, Hayward, CA 94545-4600 | 2016-06-09 |
| 1992154603 | Hope Psychotherapy, Inc | Community/Behavioral Health | 1245 B St, Hayward, CA 94541-2915 | 2016-06-03 |
| 1417311234 | East Bay Agency for Children | Community/Behavioral Health | 520 Jefferson St, Bowman, Hayward, CA 94544-4126 | 2016-04-07 |
| 1508224486 | Stars, Inc. | Community/Behavioral Health | 17115 Meekland Ave, Hayward, CA 94541-1304 | 2016-02-05 |
| Find all providers in HAYWARD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.