LAC COURTE OREILLES DAY TREATMENT PROGRAM (NPI# 1275707010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275707010 |
| Entity Type | Organization |
| Organization Name | LAC COURTE OREILLES DAY TREATMENT PROGRAM |
| Practice Address |
13380 W Trepania Rd Hayward WI 54843-2186 |
| Practice Telephone | 7156385100 |
| Practice Fax Number | 7156346107 |
| Mailing Telephone | 7156385100 |
| Mailing Fax Number | 7156346107 |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |
| Authorized Official Name | MR. JAMES DRIVING HAWK (HEALTH DIRECTOR) |
| Authorized Official Telephone | 7156385100 |
| Is Organization Subpart | Y |
| Parent Organization Name | LAC COURTE OREILLES COMMUNITY HEALTH CTR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
1486 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42135921 | 05 |
| 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 | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770985467 | Northwest Counseling & Guidance Clinic | Clinic/Center | 16092 Highway 63, Hayward, WI 54843-9775 | 2014-09-24 |
| 1437323680 | Impact Counseling Services, LLC | Clinic/Center | 15655 County Road B, Hayward, WI 54843-3251 | 2008-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831754167 | Asap-behavioral Health, Sc | Clinic/Center | 11380 W Theo Trekr Way, West Allis, WI 53214-1135 | 2019-05-02 |
| 1003375049 | Sj Counseling Services, LLC | Clinic/Center | 7726 N 80th St, Milwaukee, WI 53223-3810 | 2019-03-19 |
| 1295224657 | Northwest Counseling & Guidance Clinic | Clinic/Center | 123 S Van Buren, Green Bay, WI 54301-4441 | 2018-05-01 |
| 1801308218 | Northwest Counseling & Guidance Clinic | Clinic/Center | 915 Acacia Ln, Rhinelander, WI 54501-2806 | 2017-10-26 |
| 1790143667 | Northwest Counseling & Guidance Clinic | Clinic/Center | 1201 North 28th Street, Northwest Journey - Northern Lights, Superior, WI 54880-8556 | 2016-02-05 |
| 1417334988 | Willow Creek Ranch, Inc. | Clinic/Center | 7404 Northwest Hwy # 83, Mukwonago, WI 53149-8903 | 2015-05-04 |
| 1700018389 | Saris Counseling LLC | Clinic/Center | 3416 Association Dr, Appleton, WI 54914 | 2009-08-17 |
| 1467626606 | Impact Counseling Services, LLC | Clinic/Center | 301 Ellis Ave, Suite 1, Ashland, WI 54806-1667 | 2008-04-18 |
| 1891976478 | Future Thoughts | Clinic/Center | 2623 N 53rd St, Milwaukee, WI 53210-2326 | 2007-11-24 |
| 1982821575 | Northwest Counseling and Guidance - Northwest Journey - Superior | Clinic/Center | 1419 Hill Ave Ste B, Superior, WI 54880-1951 | 2007-04-18 |
| Find all providers with the same taxonomy | ||||
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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.