Provider Demographics
NPI:1831859529
Name:MENOMONIE AREA SENIOR CENTER
Entity type:Organization
Organization Name:MENOMONIE AREA SENIOR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HOMSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-235-0954
Mailing Address - Street 1:1412 6TH STREET EAST
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751
Mailing Address - Country:US
Mailing Address - Phone:715-235-0954
Mailing Address - Fax:715-235-1364
Practice Address - Street 1:1412 6TH STREET EAST
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751
Practice Address - Country:US
Practice Address - Phone:715-235-0954
Practice Address - Fax:715-235-1346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care