NPIMap

Organization Active NPI

Ho Chunk Nation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tomah, WI
National Provider Identifier
1427367663
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
1413 Issued in WI
Legal business name
HO CHUNK NATION
Practice address
27374 State Highway 21
Tomah, WI 54660-4501
Phone
(608) 372-5813
Fax
(608) 372-0889
NPI assigned
Oct 6, 2010
Organization subpart
Yes
Parent organization
HO CHUNK NATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Authorized official

Name
Ms. Liz M Lund
Title
Provider Network Manager
Phone
(715) 284-9851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 1413 WI Primary

Addresses

Primary practice location

27374 State Highway 21
Tomah, WI 54660-4501

Mailing address

N6520 Lumberjack Guy Rd
Black River Falls, WI 54615-5405
Phone (715) 284-9851

Other identifiers 1

IdentifierTypeStateIssuer
1413OtherWISTATE CERTIFICATION

Other names 1

  • Ho-Chunk Behavioral Health Care - Tomah Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ho Chunk Health Center13 organizations share this tax ID, including this one
Part of
Ho Chunk Health Center

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

27374 State Highway 21
Tomah, WI 54660
Phone (608) 372-1004

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1427367663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6520 LUMBERJACK GUY RD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155405",
            "telephone_number": "715-284-9851",
            "fax_number": "715-284-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27374 STATE HIGHWAY 21",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604501",
            "telephone_number": "608-372-5813",
            "fax_number": "608-372-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HO CHUNK NATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HO CHUNK NATION",
        "enumeration_date": "2010-10-06",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "LUND",
        "authorized_official_first_name": "LIZ",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER NETWORK MANAGER",
        "authorized_official_telephone_number": "715-284-9851",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "1413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CERTIFICATION",
            "identifier": "1413",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ho-Chunk Behavioral Health Care - Tomah",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ho-Chunk Behavioral Health Care - Tomah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tomah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.