Forest County Potawatomi Community
Forest County Potawatomi Community is a Dietary Manager in Crandon, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.
- Licensed in
- WI
- In the registry since
- 2006
- Specialties on file
- 15
Practice location Address checks out
8201 Mish Ko Swen DrCrandon, WI 54520-8631
Phone: (715) 478-4300
Fax: (715) 478-4300
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Federally Qualified Health Center (FQHC) (primary) | Taxonomy 261QF0400X (WI) |
|---|---|
| Dietary Manager | Taxonomy 132700000X |
| Nutritionist | Taxonomy 133N00000X |
| Pediatrics Physician | Taxonomy 208000000X |
| Community Health Clinic/Center | Taxonomy 261QC1500X |
| Dental Clinic/Center | Taxonomy 261QD0000X |
| Hearing and Speech Clinic/Center | Taxonomy 261QH0700X |
| Podiatric Clinic/Center | Taxonomy 261QP1100X |
| Radiology Clinic/Center | Taxonomy 261QR0200X |
| Mammography Clinic/Center | Taxonomy 261QR0206X |
| Clinical Medical Laboratory | Taxonomy 291U00000X |
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Taxonomy 332800000X |
| Durable Medical Equipment & Medical Supplies | Taxonomy 332B00000X |
| Eyewear Supplier | Taxonomy 332H00000X |
| Hearing Aid Equipment | Taxonomy 332S00000X |
Record details
| NPI number | 1285741306 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ned Daniels — Tribal Chairman · (715) 478-4824 |
| Other names | Potawatomi Health & Wellness Center; Potawatomi Health & Wellness Center |
| NPI enumerated | August 24, 2006 |
| Last updated in NPPES | December 9, 2020 |
| Certification date | December 9, 2020 |
| Mailing address | Po Box 396, Crandon, WI 54520-0396 |