| Organization Name: | MENOMINEE INDIAN TRIBE OF WISCONSIN |
| NPI Number: | 1518153436 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JERRY L WAUKAU (HEALTH ADMINISTRATOR) |
| Mailing Address: | W3275 Wolf River Road Keshena |
| State: | WI US |
| Postal Code: | 54135 |
| Phone Number: | 7157993361 |
| Fax Number: | 7157993099 |
| NPI Enumeration Date: | 09/25/2007 |
| NPI Last Update Date: | 09/25/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0050X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Family Planning, Non-Surgical |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility, or mobile unit providing non-surgical, family planning/reproductive services including physical examination, laboratory services such as PAP or pregnancy tests; pregnancy, pregnancy prevention/contraceptive, and nutritional counseling, and contraceptives or prescriptions for contraceptives. |