Active NPI
Community Support Center of Rusk County
- Community/Behavioral Health Agency
- Ladysmith, WI
National Provider Identifier
1730356387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 75314459
- Legal business name
- COMMUNITY SUPPORT CENTER OF RUSK COUNTY
- Practice address
- 219 W 2ND STR N
Ladysmith, WI 54848 - Phone
- (715) 532-5940
- Fax
- (715) 532-5947
- NPI assigned
- May 13, 2008
- Last updated
- Nov 18, 2008
- Organization subpart
- Yes
- Parent organization
- COMMUNITY SUPPORT CENTER OF RUSK COUNTY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Pamela Marie Olson, LICENSED CLINICAL SO
- Title
- Director Owner Clinical Coordinator
- Phone
- (715) 403-0860
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 75314459 | WI | Primary |
Addresses
Primary practice location
219 W 2ND STR N
Ladysmith, WI 54848
Mailing address
548 N Lake Ave
Phillips, WI 54555
Phone (715) 339-6449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43429800 | Medicaid | WI |
National Provider Directory
National Provider Directory- Part of
- Community Support Center of Rusk County
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1226966400000",
"number": "1730356387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "548 N LAKE AVE",
"city": "PHILLIPS",
"state": "WI",
"postal_code": "54555",
"telephone_number": "715-339-6449",
"fax_number": "715-339-6450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 W 2ND STR N",
"city": "LADYSMITH",
"state": "WI",
"postal_code": "54848",
"telephone_number": "715-532-5940",
"fax_number": "715-532-5947"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMUNITY SUPPORT CENTER OF RUSK COUNTY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COMMUNITY SUPPORT CENTER OF RUSK COUNTY",
"enumeration_date": "2008-05-13",
"last_updated": "2008-11-18",
"status": "A",
"authorized_official_last_name": "OLSON",
"authorized_official_first_name": "PAMELA",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "DIRECTOR OWNER CLINICAL COORDINATOR",
"authorized_official_telephone_number": "715-403-0860",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LICENSED CLINICAL SO"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "WI",
"license": "75314459",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43429800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ladysmith, WI
- David M. Bihrle, MD
- Donald James Briggs
- Brita Lynn Bush, FNP-C
- Karen Lee Buth, LPTA
- Elizabeth Henderson Cernohous, NP
- County of Rusk (Rusk County Memorial Hospital)
- County of Rusk (Rusk County Memorial Hospital)
- County of Rusk
- County of Rusk Dba Rusk County Memorial Hospital and Nursing Home
- Amanda Michelle Crabb, APNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.