Organization
BLACK RIVER MEMORIAL HOSPITAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH WHITE-JACOBS RN BSN MHA FACHE (PRESIDENT & CEO)
(715) 284-5361
Entity
Organization
Contact information
Practice address
311 COUNTY ROAD A STE 1, BLACK RIVER FALLS, WI 54615-8205
(715) 284-5361
(715) 284-1390
Mailing address
711 W ADAMS ST, BLACK RIVER FALLS, WI 54615
(715) 284-5361
(715) 284-1390
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
1037
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43189700
—
WI
Enumeration date
09/11/2006
Last updated
12/16/2016
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