| Organization Name: | VILLAGE OF CLEAR LAKE |
| NPI Number: | 1528011657 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOY JACKSON (DIRECTOR) |
| Mailing Address: | 457 3rd Ave Clear Lake |
| State: | WI US |
| Postal Code: | 540058905 |
| Phone Number: | 7152632804 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |