Provider Demographics
NPI:1639398670
Name:PACIFIC INTERNATIONAL, LTD.
Entity type:Organization
Organization Name:PACIFIC INTERNATIONAL, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:DRAPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-886-4550
Mailing Address - Street 1:555 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:NEKOOSA
Mailing Address - State:WI
Mailing Address - Zip Code:54457-1317
Mailing Address - Country:US
Mailing Address - Phone:715-886-4550
Mailing Address - Fax:715-886-5565
Practice Address - Street 1:555 BIRCH ST
Practice Address - Street 2:
Practice Address - City:NEKOOSA
Practice Address - State:WI
Practice Address - Zip Code:54457-1317
Practice Address - Country:US
Practice Address - Phone:715-886-4550
Practice Address - Fax:715-886-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty