NPI 1366563314

Lakeland Care INC

Organisation Exclusive Provider Organization Fond Du Lac, WI

Practice location

Address: N6654 Rolling Meadows Dr, Fond Du Lac, WI 54937-9471
Phone: (920) 906-5100

Authorised official

Name: Kim M Mickle
Title: Compliance Manager
Phone: (920) 906-5100

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in Wisconsin →

Registry record

NPI: 1366563314
Entity type: Organization
NPI issued: 3 Apr 2007
Record last updated: 4 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.