# TINA RIOS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528220472
- **Authorized official:** TINA M RIOS (LPN)
- **Authorized official phone:** (608) 643-4643

## Contact information

- **Practice address:** 601 21ST ST, PRAIRIE DU SAC, WI 53578-1068
- **Practice address phone:** (608) 643-4643
- **Mailing address:** 601 21ST ST, PRAIRIE DU SAC, WI 53578-1068
- **Mailing address phone:** (608) 643-4643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 305581031 | WI | Yes |

## Other

- **Enumeration date:** 07/01/2008
- **Last updated:** 07/01/2008