Indianhead Community Action Agency Incorporated

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

INDIANHEAD COMMUNITY ACTION AGENCY INCORPORATED

Practice address

1000 College Ave W
Ladysmith, WI 54848-2118

Phone

(715) 532-4222

Fax

(715) 532-7808

NPI assigned

Sep 6, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Antoinette Marie McCutcheon, DESIGNATED OFFICIAL

Title

Director of Community Services

Phone

(715) 532-1545

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1962984906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548480040",
            "telephone_number": "715-532-4222",
            "fax_number": "715-532-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 COLLEGE AVE W",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548482118",
            "telephone_number": "715-532-4222",
            "fax_number": "715-532-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANHEAD COMMUNITY ACTION AGENCY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "MCCUTCHEON",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF COMMUNITY SERVICES",
        "authorized_official_telephone_number": "715-532-1545",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DESIGNATED OFFICIAL"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306930698",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 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
• Julie Lynn Kammerud, DPT

• Case Management Agency in Ladysmith, WI
• Providers in Ladysmith, WI by specialty
• Case Management Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.