Provider Demographics
NPI:1689679094
Name:ST. CROIX VALLEY SHARED SERVICES, INC.
Entity type:Organization
Organization Name:ST. CROIX VALLEY SHARED SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:715-928-9977
Mailing Address - Street 1:990 MAIN STREET
Mailing Address - Street 2:STE 1
Mailing Address - City:BALDWIN
Mailing Address - State:WI
Mailing Address - Zip Code:54002
Mailing Address - Country:US
Mailing Address - Phone:715-629-1888
Mailing Address - Fax:833-434-0364
Practice Address - Street 1:990 MAIN STREET
Practice Address - Street 2:STE1
Practice Address - City:BALDWIN
Practice Address - State:WI
Practice Address - Zip Code:54002
Practice Address - Country:US
Practice Address - Phone:715-629-1888
Practice Address - Fax:833-434-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI128251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41530800Medicaid
WI527137Medicare PIN