Polk County-Dept of Administration

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

92 Issued in WI

Legal business name

POLK COUNTY-DEPT OF ADMINISTRATION

Doing business as

Polk County Home Care

Practice address

100 Polk County PLZ
Suite 180
Balsam Lake, WI 54810-9071

Phone

(715) 485-8500

Fax

(715) 485-8501

NPI assigned

Apr 17, 2007

Last updated

Oct 21, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gretchen Sampson, RN, MPH

Title

Director

Phone

(715) 485-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Polk County Home Care Doing business as

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319155200000",
    "number": "1871719237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 POLK COUNTY PLZ",
            "address_2": "SUITE 180",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548109071",
            "telephone_number": "715-485-8500",
            "fax_number": "715-485-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 POLK COUNTY PLZ",
            "address_2": "SUITE 180",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548109071",
            "telephone_number": "715-485-8500",
            "fax_number": "715-485-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY-DEPT OF ADMINISTRATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-10-21",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-485-8500",
        "authorized_official_credential": "RN, MPH"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": "92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41520900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polk County Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Polk County Health Dept
• Polk County Health Dept
• Polk County Health Dept
• Polk County Health Dept PCC Unit
• Polk County-Dept of Administration (Polk County Health Dept/Healthcheck)
• Nicole A Ruetz, BA LSW
• Karen Rusch, LCSAC, LICS
• School District of Unity
• St. Croix Regional Medical Center
• Corby Rae Stark, MA PC

• Home Health Agency in Balsam Lake, WI
• Providers in Balsam Lake, 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 Oct 21, 2011; 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.