# COUNTY OF LA CROSSE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COUNTY OF LA CROSSE
- **Other names:** Regent Manor
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1750915575
- **Legal business name:** COUNTY OF LA CROSSE
- **Authorized official:** WANDA GIBNEY (EXECUTIVE DIRECTOR LONG TERM CARE &)
- **Authorized official phone:** (608) 612-0643

## Contact information

- **Practice address:** 856 GARLAND ST E, WEST SALEM, WI 54669
- **Practice address phone:** (608) 786-0168
- **Practice address fax:** (608) 793-6604
- **Mailing address:** 962 GARLAND ST E, WEST SALEM, WI 54669
- **Mailing address phone:** (608) 786-1400
- **Mailing address fax:** (608) 793-6505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/02/2020
- **Last updated:** 03/02/2020