NPIMap

Organization Active NPI

Fond Du Lac County DCP CCS Program

  • Community/Behavioral Health Agency
  • Fond Du Lac, WI
National Provider Identifier
1679746630
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FOND DU LAC COUNTY DCP CCS PROGRAM
Practice address
459 E 1St St
Fond Du Lac, WI 54935-4505
Phone
(920) 929-3500
NPI assigned
Apr 10, 2008
Last updated
Apr 10, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
FOND DU LAC COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Ruth Ryan
Title
Business Systems Manager
Phone
(920) 929-3437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

459 E 1St St
Fond Du Lac, WI 54935-4505

Mailing address

459 E 1St St
Fond Du Lac, WI 54935-4505

Other identifiers 1

IdentifierTypeStateIssuer
41762900MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Fond Du Lac County DCP Crisis Intervention14 organizations share this tax ID, including this one
Part of
Fond Du Lac County DCP Crisis Intervention

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1679746630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354505",
            "telephone_number": "920-929-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOND DU LAC COUNTY DCP CCS PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOND DU LAC COUNTY",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "BUSINESS SYSTEMS MANAGER",
        "authorized_official_telephone_number": "920-929-3437"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41762900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.