Indianhead Community Action Agency Incorporated

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

295 Issued in WI

Legal business name

INDIANHEAD COMMUNITY ACTION AGENCY INCORPORATED

Practice address

1000 College Avenue W
Ladysmith, WI 54848

Phone

(715) 532-5594

Fax

(715) 532-7808

NPI assigned

Oct 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brett Gerber

Title

Chief Executive Officer

Phone

(715) 532-5594

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Indianhead Home Health Care Agency Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1306930698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "address_2": "1000 COLLEGE AVENUE W",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "54848",
            "telephone_number": "715-532-5594",
            "fax_number": "715-532-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 COLLEGE AVENUE W",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "54848",
            "telephone_number": "715-532-5594",
            "fax_number": "715-532-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANHEAD COMMUNITY ACTION AGENCY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "GERBER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "715-532-5594",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": "295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43106500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indianhead Home Health Care Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allen S. Hanson, MD
• Patricia A Hautamaki, PT
• Sheila Patricia Heiser, APNP
• Frank Herbes, P.T. ASSISTANT
• Imperium Chiropractic SC
• Indianhead Community Action Agency Incorporated
• Lynnette Kay Jenness, SAC-IT
• Robin Johnson, P.T.A.
• Chandler Jean Jones, DMD
• Amy Lynn Junk, ATC

• Home Health Agency in Ladysmith, WI
• Providers in Ladysmith, WI by specialty
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.