NPI 1891659215

Lac Courte Oreilles Governing

Organisation PACE Provider Organization Stone Lake, WI

Practice location

Address: 13856 W Corbine Dr, Stone Lake, WI 54876-4001
Phone: (715) 558-7939

Authorised official

Name: Mary Wolf
Title: Director
Phone: (715) 558-7939

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Wisconsin →

Registry record

NPI: 1891659215
Entity type: Organization
NPI issued: 10 Dec 2025
Record last updated: 10 Dec 2025

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.