Organization Name: | DEERFIELD CARE CENER, LLC |
NPI Number: | 1013351899 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MEGAN CORCORAN (ADMINISTRATOR) |
Mailing Address: | 575 Hospital Road New Richmond |
State: | WI US |
Postal Code: | 54017 |
Phone Number: | 7152433930 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2013 |
NPI Last Update Date: | 04/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QX0100X |
License Number: | 522626 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Occupational Medicine |
Taxonomy Definition: |