# COUNTY OF TREMPEALEAU

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COUNTY OF TREMPEALEAU
- **Other names:** Hickory Ridge Adult Family Home
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326170267
- **Legal business name:** COUNTY OF TREMPEALEAU
- **Authorized official:** JERRU DEETZ N.H.A (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (715) 538-4312

## Contact information

- **Practice address:** W17306 ARNESON RIDGE RD., BLAIR, WI 54616
- **Practice address phone:** (608) 989-2018
- **Mailing address:** W20410 STATE ROAD 121, WHITEHALL, WI 54773-9147
- **Mailing address phone:** (715) 538-4312
- **Mailing address fax:** (715) 538-2426

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 11796 | WI | Yes |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 04/15/2021