| Fond Du Lac Co Dcp Ccs Program | |
|
459 E 1st St Fond Du Lac WI 54935-4505 | |
| (920) 929-3500 | |
| Not Available |
| Full Name | Fond Du Lac Co Dcp Ccs Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 459 E 1st St, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Mary Ellen Mcmeen (DIRECTOR-MENTAL HEALTH & AODA) |
| Authorized Official Contact | 9209293500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fond Du Lac Co Dcp Ccs Program 459 E 1st St Fond Du Lac WI 54935-4505 Ph: (920) 929-3500 | Fond Du Lac Co Dcp Ccs Program 459 E 1st St Fond Du Lac WI 54935-4505 Ph: (920) 929-3500 |
| NPI Number | 1255454047 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255454047 | NPI | - | NPPES |
| 41763000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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› Verified 9 days ago
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